Retinal Holes and Tears

Retinal holes and tears are small breaks in the retina. The retina is light-sensitive tissue at the back of the eye. Usually holes and tears do not mean you will have serious vision problems right away. However, retinal holes and tears may cause problems if they allow fluid to seep behind the retina.

Image by Katie Moum

Causes 

Retinal holes and tears can be caused by a variety of conditions including PVD, high myopia (nearsightedness), and trauma.  Symptoms of retinal holes and tears commonly include flashes and floaters but may present with no visual symptoms.  If a retinal tear or hole is left untreated,  fluid may accumulate under the retina, causing a retinal detachment.

Atrophic retinal hole

Atrophic retinal holes are small round or oval holes that typically occur in the peripheral retina. This type of retinal hole is associated with degeneration (atrophy) of retinal tissue. Atrophic retinal holes are usually harmless and don’t require treatment. An estimated 5% of the general population has atrophic retinal holes.

Operculated retinal hole

Operculated retinal holes are round, oval or out-of-round holes where a plug or “cap” (operculum) of retinal tissue is pulled forward into the vitreous body of the eye where it floats above the hole. Like atrophic holes, operculated retinal holes occur more often in the peripheral retina.

Diagnosis and Testing

The diagnosis of retinal holes and tears can be made with a thorough eye examination.  Your doctor will use equipment to find the hole or tear and determine if it needs to be treated or if it can be closely monitored. It is important to have a dilated exam with an ophthalmologist if you are diagnosed with a retinal hole or tear, additional testing helps an ophthalmologist diagnose and monitor these conditions.

Treatment

Retinal holes and tears are usually treated with in-office procedures including laser therapy or cryotherapy which adhere the retina to underlying layers of the eye to prevent a retinal detachment .  If a retinal tear or hole is left untreated,  fluid may accumulate under the retina, causing a retinal detachment.