Disease Description (Causes and Symptoms)
- Definition: A retinal tear is a condition in which part of the retina is torn and a hole forms. It may be caused by traction occurring at the point where the vitreous and retina are attached.
- Causes/Pathophysiology: In most cases, it occurs when traction from the vitreous during posterior vitreous detachment (the process in which the vitreous separates from the retina) tears the retina. High myopia, trauma, and a history of retinal disease (retinal degeneration or previous surgery) are risk factors. If a tear is present, vitreous fluid may seep under the retina and progress to retinal detachment.
- Main symptoms: Sudden flashes of light (flashing), new floaters (an increase in floating objects resembling flies or dust), visual field defects (a covered or darkened area), and blurred vision (when accompanied by bleeding). There may be no symptoms in the early stages.
Treatment Methods
- Nonsurgical procedures
- Laser photocoagulation (retinopexy): Laser is applied around the tear to create scarring, preventing the tear from enlarging and preventing retinal detachment. This is the standard treatment for small tears and the stage before detachment.
- Cryotherapy (cryopexy): When laser treatment is difficult because of the location, freezing is used to produce a similar effect.
- Surgical treatment (when retinal detachment progresses)
- Vitrectomy (pars plana vitrectomy): Removal of the vitreous and reattachment of the retina, using gas or silicone oil.
- Scleral buckle: A method of closing the retinal break by pressing on the eyeball from the outside (performed alone or in combination, depending on the case).
- Medication: There is no direct medication-based method for closing a retinal tear, but antibiotics and anti-inflammatory drugs may be used to manage inflammation and infection before and after surgery.
- Lifestyle management/Precautions
- Seek immediate emergency ophthalmic care if symptoms such as flashes, floaters, or a black curtain occur.
- On the day after laser treatment, avoid excessive eye use, strenuous exercise, and rubbing the eyes.
- Regular examinations are recommended for people with high myopia or a history of retinal lesions (for example, once or twice a year, following the doctor's recommendation).
Checklist Before an Outpatient Visit (Including Items to Bring and Sample Questions)
- Items to bring
- A list of medications currently being taken (including anticoagulants and antiplatelet drugs), allergies, and previous medication reactions
- Records of previous eye surgery, trauma, and diagnoses (previous examination images or findings, if available)
- A record of changes in symptoms (when they began, what the symptoms are, and how they have progressed), and photographs (if possible)
- Information about glasses or contact lenses and an insurance card
- Information to tell the doctor first during the outpatient visit
- Whether there has been any recent trauma to the eye
- Whether flashes or floaters began suddenly and when they started
- A history of previous retinal problems (retinal detachment, laser treatment, etc.)
- Examples of questions the doctor may ask during the outpatient visit (from the patient's perspective)
- "Exactly when did the symptoms first occur?"
- "Are the symptoms gradually worsening, or have they remained the same?"
- "Have you ever had retinal surgery or laser treatment in the past?"
Examples of General Questions to Ask the Doctor
- What are the goal and expected effects of this treatment (laser/surgery)?
- How significant are the risks and complications of the treatment (progression of retinal detachment, bleeding, infection, etc.)?
- What is the possibility of recurrence after treatment, and what is the schedule for follow-up examinations?
- Do the medications I am currently taking, especially anticoagulants, affect the treatment or surgery?
- To what extent can my vision recover? When can I return to daily activities?
Examples of Condition-Specific Questions
- Considering my case (myopia, previous eye history, etc.), is laser treatment alone sufficient, and how likely is surgery to be needed?
- If I develop new floaters or flashes, should I go to the emergency room immediately, or can I first be seen at a scheduled outpatient appointment?