Retinal scarring is the development of scar tissue on, in, or under the retina, an important structure in the back of the eye. Mild scarring may not be a serious medical issue, but large scars can cause vision distortion and eventual vision loss. A care provider can evaluate a patient with retinal scarring to determine the extent and provide advice on treatment options. Treatments for this condition can be invasive, and a doctor does not want to recommend a procedure that may cause more harm than good.
Patients can develop retinal scarring for a number of reasons, including very severe myopia, ocular histoplasmosis syndrome, and wet age-related macular degeneration. It starts with irritation to the retina that causes inflammation and leads to changes in the tissue. If this occurs repeatedly, it can start to cause significant problems for the patient. It may wrinkle the surface of the retina or could cause the retina to swell. Sometimes, retinal scarring causes a retinal detachment.
Some patients may not be aware of the scars, while others may start to notice vision changes. Commonly it becomes difficult to read text, and patients may notice pattern distortions. These are the result of disruptions in the retinal surface. The classic test for macular degeneration, where a patient looks at a grid and reports any irregularities, can also show evidence of retinal scarring. Part of the grid may pull out of position or curve when the patient tries to focus on it.
For mild retinal scarring, the best treatment may be watchful waiting. If the patient has an ongoing eye condition, getting it under better control may help with the scarring, as it will prevent additional damage. If the scars are severe and cause vision loss, the patient may need surgery. An eye surgeon can carefully evaluate the eye and determine if it is possible to treat the areas of scarring. This procedure is delicate, and the patient will need to thoroughly understand the risks and benefits before proceeding.
There are certain cases where a physician may actually induce retinal scarring. In patients with retinal tears, or small holes in the retina, the surgeon may create a small scar to seal the tear and anchor the retina in place. This requires a steady hand and surgical precision. If the surgeon makes a mistake, the problem could grow worse instead of better. Patients may notice some vision distortion after surgery as the eye adjusts, but it should recover and regain normal visual acuity.