A retinal tear is a break or flap in the thin, light-sensitive tissue (the retina) that lines the back of the eye. It typically occurs when the vitreous gel — the clear, jelly-like substance that fills the eye — pulls away from the retina with enough force to cause a small rip. This is often part of a normal aging process called posterior vitreous detachment (PVD). While a retinal tear by itself doesn’t always cause vision loss, it can allow fluid to pass underneath the retina, which may progress to a retinal detachment, a sight-threatening emergency. Early diagnosis and treatment are critical to prevent that complication.
Symptoms
Sudden flashes of light (photopsia), especially in peripheral vision
New or increased floaters, sometimes described as a ‘shower of black dots’ or ‘spider webs’
Blurred or hazy vision if bleeding occurs inside the eye
Shadow or curtain effect if detachment begins
Sometimes no symptoms — tears can be found incidentally during routine eye exams
Findings
U-shaped (horseshoe) retinal tear or operculated tear in the peripheral retina
Evidence of posterior vitreous detachment (PVD) with visible traction at the tear edge
Pigment cells in the vitreous cavity (‘tobacco dust’ or Shafer’s sign)
Possible localized vitreous hemorrhage
Adjacent retina remains flat unless subretinal fluid has developed
Treatments
Goal: Prevent progression to retinal detachment by sealing the tear to the underlying retinal pigment epithelium (RPE).
Laser Photocoagulation: Uses focused laser burns around the tear to create a scar that ‘welds’ the retina in place.
Cryotherapy: Applies a freezing probe externally to create an adhesive scar when laser visualization is poor (e.g., due to vitreous hemorrhage).
Observation: In select, small atrophic holes without symptoms or traction, close monitoring may suffice.
Procedures are typically performed in-office, using topical anesthesia and minimal discomfort.
Outcomes
Excellent prognosis when treated promptly — over 90% of retinal tears remain stable without detachment.
Flashes and floaters often improve over several weeks to months.
Untreated tears may progress to retinal detachment, requiring surgical repair and carrying a higher risk of permanent vision loss.
Follow-up examinations are essential, as new tears can develop even after successful treatment.
We use cookies to ensure that we give you the best experience on our website. If you continue to use this site we will assume that you are happy with it.
