31 Jul If you have a retinal tear
If you have a retinal tear, how will your retina specialist treat the tear? There are 3 options: laser, cryotherapy or operate.
Untreated retinal tears can cause a retinal detachment. Retinal detachments are potentially blinding and require surgery. The goal of treatment is to prevent retinal detachments from developing.
Posterior Vitreous Detachment (PVD)
A posterior vitreous detachment is the usual cause of a retinal tear. Retinal holes, associated with lattice degeneration, can also lead to a retinal detachment and are treated identically to retinal tears.
Acute flashes and floaters are the most common symptoms of a PVD and should alert your eye doctor/retina specialist to look for a retinal tear.
Laser photocoagulation is the first choice of treatment. It is performed in the office and does not require anesthesia. In most cases treatment takes a few minutes. The goal is to completely encircle the tear with laser burns. The burns cause the retina to scar thereby preventing fluid to migrate underneath the retina.
Not all tears can be treated with laser, hence, cryotherapy and vitrectomy are viable options.
In order for a retinal tear to be treated with laser, the entire tear must be visible. There are situations where the tear can not be viewed completely:
Vitreous hemorrhage, often associated with retinal tears, can literally block the laser light.
Dense cataract can also absorb or block the laser energy from reaching the retina.
The edge of intraocular lenses from previous cataract surgery often block or distort the peripheral retina (location of most tears) making laser treatment impossible.
Anteriorly located in the extreme peripheral retina often can not be viewed without special instrumentation and techniques making laser difficult.
Cryotherapy combines a different viewing system along with physical manipulation of the eye to treat the retinal tear from the outside in. A cryotherapy probe is placed moved along the outside of the eye until it is adjacent (underneath) the retinal tear. The freezing induces scar formation similar to that of the laser.
In cases where neither laser nor cryotherapy are possible, vitrectomy can be an excellent solution. Vitrectomy is the basic surgery performed by a retina specialist. A special laser probe can be introduced inside the eye to laser the retina tear.
Regardless of modality: laser, freezing or vitrectomy, the results are equally the same at preventing a retinal detachment.
Follow the advice of your retina specialist or eye doctor.