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Emergency: requires immediate attention
Retinal tear - External and Internal Eye
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Emergency: requires immediate attention

Retinal tear - External and Internal Eye

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Contributors: Rachel Ellis MD, Andrew Goodfriend MD, Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD, Lauren Patty Daskivich MD, MSHS
Other Resources UpToDate PubMed

Synopsis

A retinal tear is a full-thickness break through all of the retinal layers. Tears usually occur in the periphery as a result of vitreous traction and can lead to retinal detachment. Atrophy of inner retinal layers can lead to a retinal break. According to clinical and autopsy studies, asymptomatic retinal breaks are found in 6% of eyes.

Retinal tears are associated with myopia (nearsightedness), pseudophakia (after cataract surgery), lattice degeneration, and trauma. Liquefaction of the vitreous and posterior vitreous detachments lead to vitreous traction and may lead to a break in the retina. Blunt trauma to the eye may rapidly compress the eye in the anterior-posterior plane and expand the eye in the equatorial plane, causing severe traction and possible retinal breaks.

When the vitreous fluid leaks through the tear, fluid can accumulate beneath the retina and separate the retina from the underlying retinal pigment epithelium and the choriocapillaris (blood supply). This separation of layers is called a retinal detachment. Most retinal breaks do not progress to retinal detachment.

Symptoms of floaters and flashing lights may accompany a retinal tear, though most breaks remain asymptomatic. A retinal tear (especially symptomatic ones) may progress to a retinal detachment within hours, leading to progressive visual field loss.

Codes

ICD10CM:
H33.039 – Retinal detachment with giant retinal tear, unspecified eye
H33.319 – Horseshoe tear of retina without detachment, unspecified eye

SNOMEDCT:
95690009 – Retinal tear

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Cobblestone degeneration 
  • Lattice degeneration 
  • Meridional fold 
  • Retinoschisis 
  • White without pressure 
  • Vitreoretinal tuft

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 01/24/2013
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Emergency: requires immediate attention
Retinal tear - External and Internal Eye
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Retinal tear : Floaters, Unilateral, Perceived flashing lights
Clinical image of Retinal tear
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