Can a retina detach spontaneously even when it has no tears or holes in a high myope (-10D)?

Most all retina detachments start as tears or holes. Once these develop, fluid inside the eye can slosh around and start to dissect its way under the edges of the tear, gradually lifting the retina away from its adhesion to the wall of the eye. But why are there holes or tears in the first place?

As the globe (eyeball) grows during youth, it becomes larger and thins somewhat, much like a pumpkin growing on a vine. The retina is "plastered" against the wall of the eye but does not stretch much. So if there is a lot of eyeball growth (i.e. as the diameter of the globe increases) the weakest areas of the retina (usually in the periphery) can get stretched thin and eventually break. Since "large diameter eyeballs" = myopia (nearsightedness), the higher the degree of myopia, the greater the risk of tears developing over time.

There are much more uncommon situations where a retina can detach without a tear but these are rare.

It is important for high myopes (like your -10 D. friend) to be familiar with the signs and symptoms of a retinal tear and/or detachment so as to get it treated quickly before permanent harm to vision can occur.

Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic