Retinal detachment (RD) is a serious eye condition that occurs when the retina, the thin, light-sensitive tissue at the back of the eye, pulls away from its supportive underlying tissue. This separation deprives the retina of the oxygen and nourishment it needs, which can lead to permanent vision loss. Because a detached retina is painless, the primary signs are visual disturbances that must be recognized immediately. While a patient cannot diagnose this condition at home, recognizing specific symptoms is the only way to ensure prompt professional treatment.
Recognizing the Warning Signs
The earliest signs of a potential retinal detachment are visual changes that are often abrupt in onset. One common initial symptom is a sudden shower of new floaters—small, dark specks or threads that drift across the field of vision. Floaters are shadows cast on the retina by tiny clumps within the vitreous gel. A sudden increase in the number or size of these floaters may signal a tear in the retina.
Another common symptom, known as photopsia, involves seeing flashes of light, particularly in the peripheral vision. These flashes often appear as momentary arcs of white light or “lightning streaks” and are typically more noticeable in dim lighting. Photopsia occurs because the shrinking vitreous gel pulls on the retina, stimulating the light-sensing cells. This traction can precede a full retinal tear or detachment.
The most definitive symptom is the appearance of a shadow, curtain, or veil that moves across the field of vision. This visual field loss indicates that a significant portion of the retina has already separated. The shadow may start in the periphery and rapidly advance toward the central vision. If the detachment involves the macula, the central part of the retina responsible for sharp vision, a reduction in visual acuity occurs.
Differentiating Serious Symptoms from Benign Issues
Many people experience occasional floaters as a normal part of aging due to posterior vitreous detachment (PVD). PVD occurs when the vitreous gel liquefies and pulls away from the retina. These benign floaters are static, having been present for a long time. The distinction between these common visual phenomena and a true retinal issue lies in the nature and severity of the onset.
Symptoms associated with retinal detachment are characterized by their acute, sudden onset, often involving a dramatic increase in both floaters and flashes. A sudden “burst” or “cloud” of dozens of new floaters signals a high risk of a retinal tear or detachment. Flashes associated with a tear are repetitive and occur in the same eye as the floaters. Benign flashes, such as those caused by a migraine, appear in both eyes and may present as shimmering, zigzag lines.
It is the combination of new, numerous floaters, persistent flashes, and any loss of peripheral vision that suggests an acute problem. While PVD is benign, the vitreous pulling away can tear the retina in approximately 14% of cases. Any sudden change in visual symptoms must be considered potentially serious.
Essential Steps If You Suspect Retinal Detachment
If you notice a sudden onset of new floaters, light flashes, or a shadow obscuring any part of your vision, seek immediate professional medical attention. Retinal detachment is an emergency, and the prognosis for vision preservation worsens with every hour treatment is delayed. Contact an ophthalmologist, retina specialist, or proceed directly to an emergency department.
It is important to provide the medical professional with precise information regarding your symptoms. Clearly state when the new floaters and flashes began, whether the symptoms are present in one or both eyes, and describe the size and location of any visual field shadow. This detailed account assists the medical team in preparing for a prompt dilated eye exam, which is the only way to diagnose a retinal tear or detachment.
While awaiting medical care, minimize unnecessary eye movement. Excessive eye movement can allow more fluid to pass through a retinal tear, increasing the size of the detachment. Keep your head as still as possible and avoid rubbing or putting pressure on the affected eye. Do not attempt to self-treat or wait for a routine appointment, as this delay can lead to permanent vision loss.