The retina is a thin layer of light-sensitive tissue that lines the inner surface of the back of the eye. Through its millions of cells, signals of what we see are sent to the brain where they’re interpreted into images. Certain conditions can disrupt this visual process. One of these conditions is retinoschisis.*

About retinoschisis

“Schisis” means separation or cleft. In retinoschisis, the retina is split into two or more layers. This split occurs between the light-absorbing cell layer and the layer of cells that sends signals to the brain via the optic nerve. Separations are more likely to happen at the outer edges of the retina than the center macula, but can still affect your eyesight.

There are two types of retinoschisis. 

• Congenital retinoschisis is present at birth. Also called juvenile, X-linked retinoschisis, it usually affects both eyes and develops mostly in boys and young men. The gene is carried by the mother, though mothers usually don’t develop retinoschisis.
• Acquired, or degenerative, retinoschisis usually happens in middle or older age, but can occur at younger ages, as well, and can lead to retinal holes and subsequent retinal detachment.

The Cleveland Clinic says retinoschisis is a “somewhat rare” condition. About 1 in 5,000 to 1 in 25,000 people are born with congenital retinoschisis. For the degenerative type, estimates vary from 4% of people over age 40, and up to 4% of people over age 50.

Signs and symptoms of retinoschisis

Retinoschisis may not present any symptoms. If it does occur, congenital retinoschisis can present:

• Crossed eyes
• Farsightedness
• Eyes moving side to side
• Loss of either central or peripheral (side) vision depending on split location

In acquired retinoschisis, you may have difficulty with peripheral vision.

If retinoschisis is severe, and if retinal detachment has also occurred, you may experience:

• Eye floaters and flashes
• Distortion of vision
• Loss of central or peripheral vision, depending on the split location

Diagnosing retinoschisis

After a comprehensive eye examination, your eye doctor will confirm the disorder with a series of tests to examine the retina. These may include:

• Direct and indirect ophthalmoscopy requiring pupil dilation
• Optical coherence tomography (imaging test)
• B-scan ultrasonography (imaging test, like ultrasound for the retina)
• Electroretinography (tests the eye’s response to flashing light)
• Angiography (imaging of retinal blood vessels)

Genetic testing may also be performed, if congenital retinoschisis is suspected.

Treating retinoschisis

Currently, retinoschisis can be neither cured nor prevented, but it can be managed. 

• Acquired retinoschisis may be deemed benign by your doctor, with no treatment necessary. Glasses may be needed for near- or farsightedness, for example.
• Congenital retinoschisis may also require glasses.
• Bleeding from broken blood vessels can be addressed with either observation, cold therapy (cryoablation), or laser.
• Retinal detachment requires surgery for reattachment.

Research continues on possible treatments for congenital retinoschisis, including gene and stem cell therapies, as well as the drug dorzolamide.

Living with retinoschisis

Regular eye exams are essential when living with retinoschisis. 

• Cleveland Clinic also recommends, if needed, low vision aids and learning about mobility, orientation, and adaptive technology use. 
• Additionally, support groups and other resources can offer learning, emotional support, and practical tips.

“Losing any amount of vision can be a scary thing,” writes the Clinic staff. “It’s important to know that you don’t have to manage everything on your own.”

*Cleveland Clinic. (2022, October 18). Retinoschisis. https://my.clevelandclinic.org/health/diseases/24310-retinoschisis