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Are you having trouble seeing things, focusing on nearby things, etc.?

Most of the time, it is harmless and shows that we are aging and need to take extra care of our eyes. However, not everything is harmless. Occasionally, it's a symptom of something serious affecting our eyes.

As people age, many starts noticing a phenomenon called floaters – dots, threads, haziness, cobwebs – which float across the line of vision. Sometimes, they witness flashes of light.

While floaters and flashes are generally harmless, it can also indicate a retinal tear or retinal detachment that can lead to vision loss.

Physiology

Vitreous humor (or simply vitreous) fill more than 80% of the vitreous cavity (eyeball) and helps in maintaining the shape of the eye.

Typically, floaters are particles of protein, clusters of cells (very tiny) or bits of gel that get lodged in the vitreous. These cause a shadow on the retina, a light-sensing membrane lining the back of the eye.

The retina captures and sends images via the optic nerve to your brain. Retina’s outlying parts help in with the peripheral vision.

As one moves the eyes, floaters also move and seem like darting away when you focus on them. A majority of the floaters generally settle below your line of sight.

However, it does not vanish completely. One notices floaters when looking at a uniformly bright background, like a white background or the sky.

Vitreous is a gel (mostly water) held together by hyaluronic acid molecules and collagen fibers. Floaters are typically formed due to changes related to aging, but some can be embryonic vitreous remnants.

Over time, the vitreous starts shrinking, and pulls on the retina and stimulate photoreceptors causing flashes.

Pulling can minor bleeding that starts appearing as floaters. Sometimes, one can suffer from PVD or posterior vitreous detachment, where the vitreous gets detached from the retina.

PVD can result in the creation of new floaters and occasional peripheral vision flashes.

Uncommon in people below age 50, PVDs are a common thing in nearly 65% of people aged over 70. PVD is also common in people with myopic vision, who have undergone cataract surgery, or suffered a head or eye injury.

The development of a vitreous detachment takes around a week or more.

While they are harmless, in 15 to 20% cases, it can result in retinal detachment. See an ophthalmologist if you have a sudden onset of flashes or floaters. Even if there is no problem, re-examination after six to eight weeks is recommended if there is an increase in symptomatology.

Symptoms Of a Retinal Tear Or Detachment

If there is a presence of a retinal tear, you might evidence floaters (threads or specks in the vision), flashes (stars, lights, or streaks in vision) or sudden onset of blurry vision. In retinal tear or detachment, a specific area of the vision gets shadowed.

An immediate appointment with an ophthalmologist is needed if you notice any of the symptoms mentioned above.

Treatment Options

When a retinal tear happens, the vitreous fluid tends to leak through it, causing the retina to be detached from the tissue nourishing it. A retinal detachment is a serious issue, and it’s essential to understand and recognize its symptoms.

It should be noted that every retinal tear need not cause symptoms. Fortunately, the symptomless retinal tears do not result in retinal detachment.

But in cases where they do, prompt treatment is required to prevent a full-blown retinal detachment. Around 30% to 50% of people with symptomatic tear tend to develop detachments, and preventative treatment reduces the rate to about 10%.

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During the eye examination, your ophthalmologist checks for any retinal tears through pupil dilation and examination of the eye’s internal surfaces using an indirect ophthalmoscope (a lighted device mounted on specialized headgear).

Since the chances of the underlying problem causing a tear in the other eye are high, your ophthalmologist might examine both eyes.

Once a retinal tear has been detected, the ophthalmologist will work on the treatment options (mostly in clinical setup).

The common types of treatment are photocoagulation (specialized laser treatment) or cryopexy (freezing). If the ophthalmologist detects a retinal detachment, then he or she will advise surgical repair.

Laser photocoagulation

The ophthalmologist, in laser photocoagulation treatment, uses topical anesthesia to numb the area. Then, a laser is used to create small burns around the edges of the retinal tear.

The resultant scars help in sealing the retinal tear edges, thereby preventing the vitreous to leak through and get collected under the retina. This procedure does not need any surgical incision.

Cryopexy

Cryopexy works like laser photocoagulation. In this procedure, the ophthalmologist, under topical anesthesia, freezes the back wall of your eye. This causes a scar to develop and seal the tear edges.

Cryopexy leads to the development of an adhesion reducing the likelihood of a tear turning into a detachment. Cryopexyis employed when it is impossible to reach the tear with a laser.

Regular Checkup is the Key

Fixing a retinal tear in one part of the retina does not mean that there won’t be any more tears. Regular checkup with an ophthalmologist is required if you have undergone any retinal tear treatment.

Some retinal tears might not need any immediate treatment, watchful waiting might be preferred, but it is upto the clinician to make that determination.