Retinal Detachment: Symptoms, Signs, and How a Person Sees

You notice flashes in your field of vision, floating spots, or a dark shadow that seems to advance from one side. Such signs can indicate various conditions, and retinal detachment is one where delay directly affects vision. Let us walk through how it looks and what to do.

What retinal detachment is

The retina is a thin layer deep inside the eye that perceives light. In a healthy eye, its neuroepithelium (the layer of cones and rods) is in close contact with the pigment epithelium. In detachment, these layers separate from each other because fluid accumulates between them. Most often the cause is a retinal tear: fluid from the vitreous body passes through it and detaches the retina from the choroid. A tear occurs due to traction from altered vitreous body, thinning (dystrophy) of the retina, or eye trauma. Less commonly, detachment occurs without a tear — in diabetic retinopathy, tumors, or fluid accumulation.

Early symptoms of retinal detachment

The first thing people notice is a curtain before the eye. They try to remove it by rinsing or with drops, but it does not disappear. Flashes in the form of sparks and lightning (photopsias) are characteristic, as well as floating spots and lines. Distortion of letters and objects appears, and individual areas drop out of the visual field (metamorphopsias) — this indicates that the process has involved the center of the retina. Narrowing of the visual field boundaries corresponding to the site of detachment also occurs. Remember and tell the doctor from which side the curtain first appeared: over time it may occupy the entire field of vision.

How a person sees with retinal detachment

A person may see a dark "curtain" or shadow descending from one side, with sparks and floaters flickering in front of it. Detachment may proceed without noticeable symptoms until the macula is involved. When the center is involved, letters and faces are distorted, and part of the picture disappears. This is not a diagnosis based on sensations, but a reason to see an ophthalmologist promptly.

Who is at risk

Detachment occurs more often with myopia, after eye surgery (for example, for cataract), after eye trauma, and with a family history of retinal detachment. The risk is also associated with age-related changes in the vitreous body. With myopia or retinal dystrophy, it makes sense to have regular examinations by an ophthalmologist.

• suddenly appeared or sharply increased floaters;
• flashes of light in the eye;
• a dark "curtain" or shadow in the field of vision;
• sudden blurring of vision.

How retinal detachment is diagnosed

The doctor checks visual acuity (the state of the central area), peripheral vision by perimetry, and measures intraocular pressure — the norm is 16–25 mmHg; in detachment it may be lower. Examination of the fundus (ophthalmoscopy) shows the sites of tears and thinned areas. An electrophysiological study assesses the viability of retinal nerve cells and the optic nerve, while ultrasound provides information about the size of the detached retina and the state of the vitreous body, which is especially needed with opacities of the cornea, lens, or vitreous body when the retina cannot be seen.

Why you need to see an ophthalmologist urgently

In detachment, nerve cells, rods, and cones die, and the longer the detachment exists, the worse the recovery of vision even after a successful operation. It is not treated with medication — surgery helps, and success depends on timely detection. Symptoms may return: detachment can occur more than once.

This alone is not a reason to call an ambulance; 103 or 112 — if there is a threat to life, for example signs of stroke or heart attack, severe trauma.

This material is for reference: a diagnosis is not made based on sensations alone, so if you have flashes, floaters, or a shadow in your field of vision, see an ophthalmologist — this does not replace a doctor's consultation.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer