What are the symptoms of a retinal detachment?
A retinal detachment is painless, which is exactly why the warning signs matter. Most patients notice one or more of these symptoms, often suddenly:
- Flashes of light: brief streaks or arcs, often in your side vision, especially in the dark
- A shower of new floaters: dozens of new specks, cobwebs, or a single large "cloud" drifting in your vision
- A curtain or shadow: a dark area moving in from the edge of your vision, like a curtain being drawn
- Sudden blur or loss of vision in one eye
What causes a retinal detachment?
Most detachments begin with a retinal hole or retinal tear. As we age, the vitreous gel inside the eye shrinks and separates from the retina, a normal process called posterior vitreous detachment. Occasionally the gel pulls hard enough to tear the retina, and fluid passes through the tear and lifts the retina off the eye wall.
Your risk is higher if you are very nearsighted, have had cataract surgery, have a family history of detachment, have thinning of the retina called lattice degeneration, have had an eye injury, or have had a retinal detachment in your other eye.
How we diagnose a retinal detachment
Retinal detachments are typically diagnosed either by a photo taken of the retina or with a dilated eye exam. Following initial recognition and diagnosis of a retinal detachment, we will very carefully examine the entire retina with specialized lenses to find every tear and determine how best to repair the retinal detachment.
How is a retinal detachment treated?
Treatment depends on whether a vitreous detachment has occurred, the age of the patient, and features of the detachment, such as the location of the retinal tears that caused the retinal detachment. The following are options we may discuss for how best to repair a retinal detachment.
What is recovery like?
If a gas bubble is injected in the office or in surgery, you may maintain a specific head position for several days, and you cannot fly or travel to high altitude until the bubble disappears on its own. Occasionally silicone oil is used instead of an air or gas bubble, and requires later surgery to remove the silicone oil but does allow for travel to higher elevations. Vision recovers gradually over weeks to months as the air or gas bubble disappears and the retina heals.
Following surgery you will have an eye patch over the eye, which will be removed the next day. You will begin eye drops the day after surgery and may need to maintain a certain position for a few days (such as being face down for several hours a day or spending some time during the day or at night on your side). You will be seen the day after surgery, about a week after surgery, and about a month and then 3-6 months after surgery. You should plan on having limited activity for about a week or two after surgery.
Common questions
What does a retinal detachment feel like?
A retinal detachment is painless.
Can a retinal detachment heal on its own?
A retinal detachment does NOT typically heal on its own, and almost always requires treatment. Without treatment, a retinal detachment is at high risk for progressive vision loss and eventual blindness.
Is retinal detachment surgery painful?
The surgery itself is done with anesthesia and most patients are comfortable. Afterward, expect scratchiness and mild soreness for a few days rather than significant pain.
How quickly do I need surgery?
How quickly you may need surgery depends on whether the center of your vision (the macula, and especially the center of the macula, called the fovea) is still attached. If it is, repair is typically urgent, often within a day or two, to preserve your central vision. In some cases, chronic retinal detachments that do not yet involve the fovea can be treated with less urgency, but you should be evaluated urgently to determine how quickly you may need surgery.
Will my vision return to normal?
Many patients recover excellent vision, especially when the detachment is repaired before it reaches the macula. If the macula has detached, vision usually improves substantially but may not return fully to normal.
Can I fly after surgery?
It is strictly prohibited to fly while a gas or air bubble is in your eye as changes in altitude with air travel may cause an elevated eye pressure that can lead to permanent blindness. You should also not travel, even by car, above certain elevations, which will be discussed with you before and after surgery. We'll tell you exactly when it's safe to travel.
This page is educational and is not a substitute for an examination. Content follows guidance from the American Academy of Ophthalmology and the American Society of Retina Specialists.