1. Am I at risk of Retinal Tears and
Detachment?
The common risks for retinal tears and detachment are:
1. Age > 50 years old
2. Family or personal history of retinal detachment
3. History of intraocular surgery
4. History of trauma
5. History of high myopia (> -6D)
6. Peripheral retinal degeneration
• e.g. Lattice degeneration
7. Retinal disease
• e.g. diabetes, hypertension
8. Retinal inflammation
What are the treatments available?
Treatment for Retinal Tear
Laser therapy or cryotherapy is done to create a scar around
a retinal hole and tear, to prevent it from enlarging and also
prevent fluid from leaking in. This procedure can be done as
an outpatient procedure (in the absence of retinal detachment), or as part of retinal reattachment surgery.
Treatment of Retinal Detachment
Treatment options all involve reattaching the detached
retina to stabilize and prevent worsening of vision. However, treatment does not always result in pre-detachment
vision and prognosis depends on whether the macula is
involved, and the duration from detachment to treatment.
Vitrectomy is a surgical procedure to remove the vitreous
gel that caused traction on the retina. The surgeon inserts
fine instruments into the eye to remove the gel, remove scar
tissue, flatten detached retina and repair tears and holes in
the retina.
Scleral buckling involves placing a silicone sponge or plastic
placed outside the globe at the site of the retinal detachment.
The material is sewn to the eye and is usually left in place
permanently to indent (“buckle”) the globe to bring it closer
to the detached retina. The buckling effect on the globe
relieves the traction (“pull”) on the retina.
Please discuss with your surgeon the various surgical
and treatment options available that are suitable
for your condition.
Retinal Detachment advice
When should I return for an immediate assessment?
1. Any sudden onset of flashes and floaters, or increase in
number of floaters.
2. Blocked vision in the periphery or centrally
3. Blurred vision.
What precautions should I take?
1. Wear safety goggles if you engage in contact sports
(e.g. squash, basketball, soccer) or high-risk occupations
(e.g. engineer, construction) to reduce your risk of eye injury
• Avoid contact sports that preclude use of safety goggles
in the acute phase (e.g. martial arts, rugby)
2. Be aware of the symptoms that accompany retinal detachment
and be sure to consult an ophthalmologist immediately
3. Always turn-up for your scheduled follow-up appointments
with your ophthalmologist.
Eagle Eye Centre @ Mount Alvernia
Mount Alvernia Hospital
820 Thomson Road, #02-10/17, Medical Centre Blk B, Singapore 574623
Tel: 6456-1000 / 6-eagleye (6324-5393) Fax: 6456-1006
Eagle Eye Centre @ Mount Elizabeth
Mount Elizabeth Medical Centre
3 Mount Elizabeth, #08-02, Singapore 228510
Tel: 6836-0001 Fax: 6836-0002
Eagle Eye Centre @ Parkway East
Parkway East Medical Centre
319 Joo Chiat Place, #05-03, Singapore 427989
Tel: 6348-1000 Fax: 6348-1001
Eagle Eye Centre @ Mount Elizabeth Novena
Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-22/23/24, Singapore 329563
Tel: 6570-1000 Fax: 6570-1001
(Picture courtesy of
www.retinatucson.com)
Email: eec@eagleeyecentre.com.sg
Website: www.eagleeyecentre.com.sg
RETINAL TEARS
& DETACHMENT

2. What is the Retina?
What are the common forms of Retinal
detachment?
Healthy Retina
The retina is the light sensitive membrane that lines the
inner layer of the eyeball much like the film in a camera.
Light from objects enter the eye and are focused onto the
retina. The retina transmits visual signals to the brain via the
optic nerve and that allows us to process the images. The
central retina (called the ‘macula’) is responsible for clear
central vision and colour vision, whilst the peripheral retina
is responsible for peripheral navigational vision and night
vision.
What is a Retinal hole / tear?
(Picture courtesy of
www.eyecaremanual.com)
Retinal detachment occurs when fluid enters through a
retinal hole or tear and accumulates behind the retina,
separating it from its underlying tissue. This is an emergency situation which requires immediate medical attention to preserve vision. The separation of the retina from its
underlying tissue results in a lack of oxygen and nutrients to
the light sensitive cells of the retina known as the photoreceptors. If left untreated, damage to the photoreceptors will
result in permanent loss of vision. Bleeding may also occur
if blood vessels are involved in the retinal tear.
What are the signs and symptoms of
retinal tears & detachment that I
should be looking out for?
Floaters
This appears as spots or
strands of black or semitransparent ‘debris’ in the
vision that moves with eye
movements.
It is often described as a
cobwebs or flies.
This is more commonly seen under the sun, bright
lights and against the sky or white background.
Flashes
This appears as brief lightning streaks usually in the
periphery.
It occurs due to vitreous pulling on the retina and may
precede floaters.
It is induced by eye movements and is best seen under
dim illumination.
Unlike floaters, the location of the flashes is unrelated
to the location of the break.
Blocked vision
This is usually described as
‘a falling curtain or veil’ that
obscures part of vision.
The area of blocked vision
corresponds to the location
of the retinal detachment.
Retinal Tear
The eye is filled with a jelly-like substance known as the
vitreous, which is in contact with the retina and responsible
for the shape of our eyeball. With age, the vitreous gel liquefies and shrinks in size causing it to separate from the retina.
This separation may pull on the retina causing a retinal tear.
The danger of a retinal tear or hole lies in its risk of progression to a retinal detachment, which can cause blindness if left
untreated.
Retinal Detachment
Occasionally retinal detachment can also occur in conditions
such as poorly controlled diabetes with severe eye disease
(proliferative diabetic retinopathy). In these cases, scar tissue
forms on the retina due to abnormal growth of vessels. This
scar tissue can contract pulling the retina away from the back
of the eyeball (tractional retinal detachment). If the macula
is involved, an emergency surgery is required to preserve
vision.
Blurred vision
This occurs when the detachment progresses to involve
the central vision (or ‘macula’).
This may be associated with distorted vision in early
stages.
No symptoms
Retinal breaks in the periphery often go unnoticed
until a detachment occurs.