How a tear happens
The vitreous is the clear gel that fills the eye. With age it liquefies and shrinks, and at some point, usually between 50 and 70, it separates from the retina, an event called a posterior vitreous detachment that most people experience as a sudden increase in floaters. Where the gel is stuck firmly to the retina, the separation can tug hard enough to tear it. The same pulling stimulates the retina and produces flashes. Nearsighted eyes, eyes that have had cataract surgery, and eyes with an injury are at higher risk.
Symptoms
A sudden onset of floaters, often described as a shower of specks, a cobweb or a large single floater; brief flashes of light like lightning at the edge of vision, most noticeable in the dark; and sometimes a small hemorrhage that appears as a smoky haze. A tear itself does not reduce vision. A shadow or curtain in the peripheral vision means the retina may already be detaching.
Why it is urgent
Most posterior vitreous detachments do not cause a tear, but around one in ten do, and a tear cannot be distinguished from a harmless vitreous detachment without a dilated examination of the whole peripheral retina. The examination should be done the same day, and repeated a few weeks later, because a tear can develop late as the gel continues to separate.
Treatment
Laser retinopexy: after dilation and a numbing drop, a laser is applied through a contact lens in a ring around the tear, creating small burns that scar the retina to the wall of the eye over the following two weeks and wall off the tear so fluid cannot pass through it. It is typically a brief office procedure and is mildly uncomfortable at most. Freezing treatment (cryotherapy) is used for tears the laser cannot reach. Both are performed by a retina specialist, to whom we refer promptly. Activity is limited for a couple of weeks while the seal forms. Tears that have already started to detach the retina need repair by a retina specialist, to whom we refer immediately.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is what is affecting your vision is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Bavand Youssefzadeh, DO. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
