Detached retina

Also called Retinal detachment

Sudden floaters, flashes or a curtain across the vision. Same-day eye assessment saves sight; waiting until Monday loses it.

What it is

The light-sensitive layer at the back of the eye peeling away from its blood supply. Without prompt surgery the detached part dies and the sight it carried is lost permanently.

It is a genuine emergency with a short window. Surgery before the central vision is affected usually preserves good sight; once the macula has detached, the outcome is much worse even with successful surgery. That is why the advice is same day, not next appointment.

Risk is much higher with severe short-sightedness, after cataract surgery, after an eye injury, in diabetic retinopathy, in Marfan syndrome, and where a close relative has had one.

The warning symptoms usually arrive before the detachment itself: a sudden increase in floaters, flashes of light, and then a shadow or curtain moving across the field of vision. Those are the moment to act.

Posterior vitreous detachment, a common and usually harmless age-related change, causes similar floaters and flashes, and a small proportion tear the retina. Because they cannot be distinguished by symptoms, every sudden onset of floaters and flashes needs examining within 24 hours.

Optometrists can assess this. High street opticians will see urgent cases the same day and are often the fastest route.

Signs you might notice

A sudden increase in floaters: specks, threads or cobwebs drifting across the vision.

Flashes of light, particularly in the peripheral vision, often more obvious in the dark.

A dark shadow or curtain spreading across part of the vision, from the side, above or below.

Blurred or distorted central vision.

Painless. There is no pain with a retinal detachment, which is part of why it gets underestimated.

Same day, without exception: any sudden onset of floaters or flashes, or any shadow across the vision. Go to an optometrist, an eye casualty or A and E.

Do not wait to see whether it settles, and do not book a routine appointment.

How it can affect day-to-day life

The absence of pain is the trap. People assume a serious eye problem would hurt, and floaters seem trivial, so they wait.

After surgery, some people have to posture, holding the head in a particular position for most of the day for up to a week or two, which is genuinely gruelling and needs planning and support at home.

If a gas bubble is put in the eye, flying and travelling to altitude are forbidden until it has gone, and nitrous oxide anaesthesia must be avoided. A wristband is usually given, and that information must reach any other clinician.

Vision recovery is gradual over months and is often not complete, and expectations set clearly in advance help.

The other eye is at raised risk, so knowing the symptoms matters for life.

Supporting someone well

Learn the three symptoms: new floaters, flashes, curtain. Any of them means same day.

Go to an optometrist, eye casualty or A and E; do not wait for a GP appointment.

Say the words retinal detachment; it changes the triage.

For anyone very short-sighted, after cataract surgery, or with a family history, make sure they know the symptoms in advance.

After surgery, arrange practical help for the posturing period; it is harder than it sounds.

Carry the gas bubble wristband and tell any clinician, especially before any anaesthetic or flight.

Report the same symptoms in the other eye immediately.

Keep diabetic eye screening appointments.

Where to get help

A high street optometrist the same day, an eye casualty department, or A and E.

The hospital eye service for surgery.

RNIB helpline: 0303 123 9999.

Fight for Sight for information on eye conditions.