Understanding TFCC Tear: Anatomy
The TFCC (tears of the cornea) are tears in the top layer of your eye. They occur when you have a sudden impact or fall on your eyes. These tears can cause temporary blindness and even permanent damage if left untreated. There are two types of TFCC tears: anterior and posterior. Anterior TFCC tears usually occur after trauma such as falling from great heights, being hit by a car, getting run over by a truck, etc.
Posterior TFCC tears happen when you’re struck with something like a sharp object or fall off of furniture. Both types of tears can lead to vision loss and other problems.
TFCC Tears: Causes & Symptoms
Anatomy: What causes TFCC Tears?
There are several possible reasons why you might experience TFCC tears. Some of these include:
Trauma – A direct blow to the eye or head, such as a hard object, bumping into another person or vehicle, etc. Eye injury – Getting hit by a ball during sports, getting burned by hot objects like candles, sunburns, water bottles thrown at you while playing outside in the summer heat.
Symptoms: What are the signs of a TFCC tear?
You may experience one or several of the following symptoms if you have a torn TFCC:
Eye pain – This is one of the most common symptoms. It occurs after an impact to your eye or head, and doesn’t get better after a few hours. Vision loss – Even if you don’t experience eye pain, you might lose sight in one or both of your eyes.
TFCC Tears: Diagnosis & Tests
Diagnosing a tear can be complicated. Your eye care specialist will ask you about your medical history and give you a general inspection of your eyes using an instrument known as a slit lamp. If the doctor notices that you have a torn TFCC, he or she will apply some dye to your eye and look inside to see what’s wrong with the tear. You may also have to undergo other eye tests to make sure there is no permanent vision loss or damage to other parts of your eyes.
TFCC Tears: Treatment
Your eye care specialist will work with you to determine the best treatment for your specific case. Some of these treatments include:
Pain medication – Your doctor may prescribe non-steroidal anti-inflammatory drugs (NSAIDs) or other painkillers.
Steroid eye drops to reduce inflammation
Corticosteroid injections to reduce inflammation
Surgery – If the tear is larger than usual, your doctor may recommend surgery. Certain instruments are used to remove the torn part of your cornea and then seal the wound with a graft. The success of this surgery depends on the size and location of the tear. While some people have only one eye repaired, others might require both eyes be repaired at the same time.
There are two types of surgery for treating TFCC tears: primary closure and secondary closure.
In the first type of surgery, your eye surgeon will clean and sterilize the area around the tear and then close it in one go. This is a more common procedure.
In the second type of surgery, your doctor will clean and sterilize the area (primary closure). After administering anesthetic, he or she will make a smaller incision. The surgeon will then remove the torn part of the cartilage and use a graft from another part of your body to seal the wound (secondary closure).
If the tear is very large, your doctor may want to first place a temporary bandage over the eye to protect it from injury before surgery. This type of surgery takes longer because it involves making two incisions, one for making the initial repair and another to place the graft. If the tear is very large, the surgeon may only be able to partially close it.
What is the prognosis?
Many people with a torn TFCC are able to regain normal or near-normal vision after treatment. In most cases, vision loss or blurriness from this condition is only temporary However, some people suffer from permanent vision loss. The chances of this happening are higher if you have diabetes or if the tear is not treated immediately.
Whether the tear is temporary or permanent, it’s a good idea to follow your doctor’s recommendations. Not following through with treatment can cause other complications like glaucoma, cataracts and retinal detachment.
Surgery is not recommended for people with certain medical conditions or older people whose TFCC tears are the result of old age. In some cases, surgery may worsen vision or even cause a retinal detachment. Your eye surgeon will discuss the pros and cons of your treatment plan with you in detail.
Sources & references used in this article:
Triangular fibrocartilage complex tears by AK Ahn, D Chang, AM Plate – Bull NYU Hosp Joint Dis, 2006 – pdfs.semanticscholar.org
Foveal TFCC tear classification and treatment by A Atzei, R Luchetti – Hand clinics, 2011 – hand.theclinics.com
The innervation of the triangular fibrocartilage complex: nitric acid maceration rediscovered by R Gupta, SD Nelson, J Baker, NF Jones… – Plastic and …, 2001 – journals.lww.com
Arthroscopic one-tunnel transosseous foveal repair for triangular fibrocartilage complex (TFCC) peripheral tear by JH Park, D Kim, JW Park – Archives of orthopaedic and trauma surgery, 2018 – Springer
The traumatized TFCC: an illustrated review of the anatomy and injury patterns of the triangular fibrocartilage complex by MR Skalski, EA White, DB Patel, AJ Schein… – Current problems in …, 2016 – Elsevier
New Tuohy needle technique for triangular fibrocartilage complex repair: preliminary studies by W de Araujo, GG Poehling, GR Kuzma – Arthroscopy, 1996 – arthroscopyjournal.org
