The vitreous is a clear gel-like substance that fills the back cavity of the eye and attached in areas to the retina. As we age, the gel separates from the retina forming a posterior vitreous detachment. This almost always happens without any issues. However, some people have an inherently more-sticky vitreous and as it separates, it sticks to the retina and pulls on it causing tears to develop. The symptoms of a possible tear are frequent flashing lights or an increase in floaters.
If they are identified early they can be treated in the office with laser treatment or a freezing treatment to the retina called cryotherapy. These treatments are very effective at preventing development of a retinal detachment. After a tear has been treated, there remains a future risk of development of new tears of the retina so continued monitoring is important. Not all tears require treatment. If there is no traction on a tear or if it has developed significant adhesion around the tear, it can often be followed without treatment.