Dr. Clayton Kirk, MD

Clayton Kirk, MD

diagram Posterior vitreous detachment The posterior vitreous detachment, retinal tear, and retinal detachment can be thought of as a three-part progression of a single entity. The retina is a very delicate layer of tissue that lines the inside of the back of the eye the way wallpaper lines the inside of a room. Filling this room is a large piece of Jell-O called the vitreous body. This Jell-O body is well attached to certain portions of the wallpaper. As it ages, the vitreous begins to liquify and crumple in on itself. This means that the attachments between the vitreous and the retina must be broken. This situation, called a posterior vitreous detachment, is both common and benign. It occurs in 60% of people over the age of 60 and can leave a residual floater in our vision.

In rare cases, a posterior vitreous detachment can cause a tear in the retina. This happens when an area of attachment between the vitreous and the retina is particularly strong. In this situation, water can get in through this tear and begin to peel the retina from its nutrition supply, like dumping a bucket of water in behind the tear in the wallpaper. This is called a retinal detachment. Because retinal tears can develop into retinal detachments, tears must be urgently evaluated by a retina specialist. If caught early, tears can be treated with a laser procedure in clinic. The laser functions to place spot welds around the retinal tear, just like putting nails into the wallpaper to prevent it from falling. This prevents a retinal tear from progressing into a retinal detachment. Tears in the retina may appear as flashes of light in our vision, as if someone was taking a picture of us from the side.

As we discussed, the final stage of this progression is called a retinal detachment, which occurs when enough water has gotten in behind the retina. This is often seen as a dark shadow or curtain in our vision. These begin from our peripheral vision and slowly progress to the center, often taking hours or even days. Unfortunately, retinal detachments require a surgery to repair. While fixable, it is possible that we won’t get 100% of our vision back after a retinal detachment, even after a successful surgery.

It is important to note that this sequence of events can happen relatively quickly, leading to some level of vision loss that can be permanent. For this reason, it is extremely important to notify an eye doctor if you begin to develop floaters, flashing lights, or a curtain coming over your vision.

BIO: Dr. Clayton Kirk completed a retina fellowship and is certified by the American Board of Ophthalmology. He practices at Eye Surgeons Associates’ Bettendorf and Rock Island offices. For more information, please visit our retina page.

The material contained in this article is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider.