A retinal tear has similar symptoms of those with a posterior vitreous detachment [link to PVD page]. As the vitreous separates from the retina, it can cause a variety of symptoms, including new flashes or floaters. A retinal tear also causes flashes and floaters, and is indistinguishable from a vitreous detachment without a dilated examination. In a percentage of patients, there will be no symptoms and retinal tears may be discovered during routine examination by ophthalmologists. The following are a more detailed description of the common symptoms of PVDs/retinal tears:
Floaters – Patients may experience an increase in floaters–both large and small. The large floater is sometimes referred to as a Weiss Ring which is a piece of collagen that has pulled off from around the optic nerve giving it a ring appearance. Also, patients may perceive many small black dots sometimes described as black pepper flakes in the eye. These tiny floaters can be blood or pigment cells that have been released from the retina when a tear is present. Only a careful dilated eye examination can determine the origin and cause of the floaters.
Flashes of Light – The retina is a neurosensory tissue designated to sense light and send those signals to the brain. When physically irritated by traction from the jelly in the eye, the retina will send false signals of light to the brain. The patient will perceive flashing light or “lightning bolts” in their vision. These flashes can be blamed on the normal, spontaneous separation of the vitreous jelly as it peels off of the retina or possibly a retinal tear. Either way, when a patient is experiencing new flashes of light, the best way to determine if there is a retinal tear or detachment is to have an ophthalmologist perform a dilated exam of the peripheral retina.
Curtain of Blurred Vision – If a retinal tear has formed, ocular fluid can begin to migrate through the retinal tear and under the retina causing a retinal detachment. These detachments will originate in the peripheral retina and are often not visually significant. However, as more fluid accumulates under the retina propagating the detachment, patients will notice a dark curtain of blurred vision opposite of where the retina is detaching. These symptoms require urgent examination to determine the cause of the loss of vision before retinal tear treatment.
Complications Of A Retinal Tear
Over time, the vitreous jelly that fills the eye becomes less like jelly and more like water. During this degradation, the vitreous can peel off of the retina and cause tears. Subsequently, the water that fills the eye can go through the tear and under the retina causing a retinal detachment. Referring back to the previous analogy, the eye is like a fluid-filled room with the retina being like the wallpaper in the room. If a tear existed in the wallpaper, fluid could seep underneath it. If enough water got underneath the wallpaper, it would start to peel off and detach. The same is true for the retina. Early recognition of a tear and prompt retinal tear treatment can prevent a large retinal detachment requiring invasive surgical repair.