You’re minding your own business when, seemingly out of nowhere, you start to see tons of small, dark spots and squiggly lines floating across your field of vision. What gives?
You’ve likely had eye floaters before, but this looks different. It could be a symptom of a detached or detaching retina, and you should see your eye doctor ASAP to find out what is going on, says Julia Haller, MD, ophthalmologist in chief of Wills Eye Hospital in Philadelphia.
A retinal detachment can occur when your retina (the light-sensitive layer of tissue in the back of your eye) breaks away from its normal position. When your retina detaches, it is cut off from its oxygen and nutrient supply, leading to the death of the tissue.
“It can cause permanent vision loss if you don’t seek care right away,” Dr. Haller says.
Often, a retinal tear precedes full-on detachment, and catching it at this stage is the better scenario, Dr. Haller says. Getting ahead of a retinal detachment starts with knowing the four symptoms that can indicate a serious eye problem, including:
As you get older, you may see floaters, which are actually small clumps of fiber or protein inside your eye’s vitreous humor. Your vitreous humor is the gel that fills the space between the lens and retina of your eye, and it shrinks as you age, causing floaters.
“Retinal detachment is different,” Dr. Haller says. “This would be an abrupt onset of a significant number of new floaters.”
A torn or detached retina may also cause flashes of light to appear in one or both eyes.
“These may look like fireworks going off in your eyes,” says Purnima Patel, MD, a clinical spokesperson for the American Academy of Ophthalmology and an assistant professor of ophthalmology at Emory University in Atlanta.
As your retina starts to detach, you may see a dark shadow or curtain on the sides or in the middle of your field of vision. “This occurs because fluid goes underneath the tear,” Dr. Haller says. You may notice a darkening of your side or peripheral vision, she says.
Your retina sends visual signals to the brain via the optic nerve. When detachment occurs, vision may be blurry, Dr. Patel says.
There is no pain with a detached retina, Dr. Haller says, but if you notice symptoms that do suggest your retina may be torn or detached, time is of the essence. “The longer it stays detached, the worse your vision will be,” she says.
About one in 10,000 people experience a retinal detachment each year.
Some people are at greater risk for a detached retina, according to the National Eye Institute.
previous cataracts, glaucoma, or another type of eye surgery
trauma to the eye
family history of retinal detachment
diabetic eye disease, a silent sign of diabetes
other eye diseases
long eyes (“If you have longer than average eyes, your retina becomes stretched, so it is more prone to tears and holes,” Dr. Patel explains.)
Your eye doctor will perform a dilated eye exam to see if there is a tear or detachment. To do this, your doctor will use eye drops to dilate or widen your pupil and then look at your retina. Sometimes more imaging tests are necessary for a better view of your retina.
There are three types of retinal detachment, according to the National Eye Institute.
This is the most common type of retinal detachment. It occurs when your retina has a tear or break, and vitreous humor gets behind your retina, pushing it away from the back of your eye.
This occurs when too much fluid builds up behind your retina and pushes it away from the back of your eye, causing it to detach. There are no tears or ruptures with this type of detached retina.
This may occur if scar tissue on your retina pulls your retina away from the back of your eye.
“Laser repair is a treatment option,” Dr. Patel says. If you catch a tear before it becomes a retinal detachment, your doctor can use a laser to seal it. Another treatment, injecting air or gas into your eye, can push your retina back into place, Dr. Patel says. Sometimes surgery is necessary if the retinal detachment is large enough, she says. Surgery involves placing a band around the white part of your eye (the sclera) to push the sides of your eye inward toward your retina so it will reattach.
For another procedure, vitrectomy surgery, your eye doctor crafts small openings in your eye wall to remove most of the vitreous gel.
See an eye doctor if you notice any of the four main symptoms of a detached retina: new floaters, flashing lights, curtains or shadows, or blurry vision.