Retinal Tear

Retinal Tear
SYMPTOMS Typically reports flashes and/or floaters but can also be asymptomatic
SIGNS A red linear or horseshoe shaped lesion in the peripheral retina. Gray-white tissue will be attached to the red linear or horseshoe shaped lesion (called a flap)
There may be a white-gray cuff surrounding the red lesion that represents edema or RPE pigment surrounding the red lesion that represents stability/chronicity
Other signs include Preretinal hemorrhages, Subhyaloid hemorrhages, Intravitreal hemorrhages, Intraretinal hemorrhages, Shafer sign
WORK-UP Full eye exam with dilated retinal exam, Scleral depression, Peripheral 90D, Gonioscopy 3-mirror (using retina mirrors)
TREATMENT Patient should sleep with their head elevated in presence of a preretinal, subhyaloid, and/or intravitreal hemorrhage
Consider discontinuing or lowering the dosage of any blood thinners in the presence of a preretinal, subhyaloid, and/or intravitreal hemorrhage (needs to be discussed with PCP)
Refer to retinal specialist STAT for further evaluation and treatment
FOLLOW-UP Once retinal tear is treated by a retinal specialist and the retina is stable, the patient should be seen back in 6-12 months
ADDITIONAL LAB | TESTS None
ETIOLOGY A tear in the retina that occurs due to vitreoretinal traction. Flap (represents torn retinal tissue) will be attached to the retina and the vitreous
DIFFERENTIAL DX Retinal hole, Retinal detachment, Retinoschisis
NOTES About 30% of retinal tears have the potential to eventually develop into a retinal detachment
The presence of a fluid cuff around the retinal tear could represent intraretinal edema or a subclinical sensory retinal detachment
The presence of RPE pigment surrounding a retinal tear indicates presence and stability of the retinal tear for at least 3 months
The size of a flap will shrink over time
Retinal dialysis is a large retinal tear at the ora serrata that is typically associated with trauma
Retinal Tears: Retinal photo demonstrating a horseshoe retinal tear completely surrounded by laser scars https://www.researchgate.net/figure/A-horseshoe-retinal-tear-surrounded-by-a-triple-row-laser-photocoagulation-Laser_fig6_333056457
Posted in Ocular Conditions, Retina-Periphery