The vitreous gel fills the inner two thirds of the eye. The vitreous is firmly attached to the retina, the inner lining of nerve tissue within the eye that is responsible for "transducing" light rays into nerve signals. As we get older, the vitreous gel begins to undergo age related changes, and it may separate from the retina. Although this may result symptomatically in nothing more than a few floaters, sufficient pulling of the vitreous on the retina may occasionally result in a retinal tear.
If vitreous fluid passes through the retinal tear and collects under the retina, causing a physical separation between the retina and its underlying supporting cellular layers, a retinal detachment will occur. Retinal detachments may cause significant and progressive vision loss and require surgical intervention for repair. Ideally, retinal tears can be identified and treated with either laser surgery or cryotherapy prior to the development of retinal detachment.
Conditions that may increase the risk for retinal tearing and detachment include, nearsightedness, congenital or acquired peripheral retinal thinning, family history of retinal tears and detachment, intraocular surgery such as cataract surgery, history of retinal tear or detachment in the fellow eye, and trauma.
A special type of retinal detachment may occur in diabetic patients who develop scar tissue membranes within the vitreous cavity. Scar tissue may cause tractional pulling on the retina, resulting in the loss of properly functioning retinal tissue. Vitrectomy in these patients will often result in stabilization of the disease as well as significant improvement in vision.
Signs and symptoms of retinal tears and detachment include flashing lights, floaters, a sense that a veil or curtain is obstructing your peripheral field or side vision, and a sudden drop in the quality of your central vision. If you experience any of these symptoms, please call your ophthalmologist immediately. Early intervention may help to preserve your vision.