Patient guide
Higher risk of retinal detachment: what to watch for
By Dr. Sam Khoury, Optometrist4 min read
Call the same day if any of these start: a sudden shower of new floaters, flashes of light, or sudden blurring. A shadow or curtain across any part of your vision should not wait for office hours at all. If the office is closed, or you cannot reach us, go to a hospital emergency room — most have an ophthalmologist on call. (609) 246-0236
Most people never have a retinal detachment. Some eyes are more likely to, and in those eyes what makes the difference is recognizing the first signs and being examined the same day. A detachment found while the center of the retina is still attached usually preserves far more vision after repair than one left to spread.
Who is at higher risk
- Nearsightedness, especially a strong prescription. A nearsighted eye is longer, and the retina is stretched thinner at its edges.
- Lattice degeneration — thin patches at the edge of the retina, seen only at a dilated examination. It is common, and most people with it never have a detachment.
- A tear or detachment in your other eye.
- Previous cataract surgery. The increased risk is highest in the first months and stays above average for years afterwards.
- A previous eye injury, even one from years ago.
- A family history of retinal detachment.
Being in one of these groups does not mean a detachment is likely. It means the warning signs deserve a faster response.
The moment that matters
The gel that fills the eye separates from the retina in almost everyone eventually, usually between 45 and 65, and earlier in nearsighted eyes. As it pulls away it can tear retina that is thin or stretched. Most tears happen at that moment, and the first flashes and floaters are the signal that it is happening.
A tear found early can usually be sealed with a laser by a retinal specialist. Left alone, fluid can pass through the tear and lift the retina away — a detachment, which needs surgery. That is why the first signs are a same-day matter, not something to watch for a few days.
The warning signs
- A sudden shower of new floaters — dots, threads, cobwebs, or a haze.
- Flashes of light at the edge of your vision, often easier to notice in dim light.
- A shadow or curtain spreading in from the edge of your vision.
- Sudden blurring that does not clear with blinking.
Check each eye on its own
With both eyes open, the good eye can hide a shadow in the other. Now and then, and whenever something seems different, cover one eye and look at something fixed, such as a doorframe, and notice whether any part of the edges is missing or shaded. Then switch.
What you can do now
- Keep up dilated examinations. The edges of the retina, where tears and lattice are found, can only be seen with the pupil dilated.
- Wear protective eyewear with polycarbonate lenses for racquet sports, contact sports, and work where anything can fly or strike the eye.
- Save the office number in your phone, and know that after hours the answer is a hospital emergency room.
Does lattice degeneration need laser treatment?
Usually not. Most lattice is watched rather than treated. Certain findings at an examination, such as a tear, or new flashes or floaters (which are a same-day call), can lead to referral to a retinal specialist for preventive laser.
My child is nearsighted. Does this apply to them?
The risk rises as nearsightedness increases, and most of that increase happens in childhood. That is one reason slowing nearsightedness in children matters. See how myopia management works.
I already have flashes or floaters. What now?
Call today. New flashes or floaters need a dilated examination the same day, and this page explains why.
Call the office
If you are in one of these groups and have not had a dilated examination recently, call to book one.
Khoury Eye Care, Hamilton Mall, 4403 Black Horse Pike, Mays Landing.