Retinal detachment: danger to vision

Many people see tiny black dots or “flying gnats” when looking at the sky or a white surface. This is usually a sign of a harmless clouding of the vitreous body in the eye. However, if whole “swarms of mosquitoes” or flashes suddenly appear, this can indicate a retinal detachment. Then you should see an ophthalmologist immediately because, in the worst case, a retinal detachment can lead to blindness. Here, you can learn how to recognize the symptoms of a retinal detachment and the possible causes.

Retinal detachment: ophthalmological emergency

In a retinal detachment (technically called retinal detachment or retinal retinal detachment), the top layer of the retina detaches from the underlying layer of pigment cells. The areas of the detached retina can then no longer be adequately supplied with blood because there is no contact with the blood vessels that run below the pigment cell layer. This leads to the death of photoreceptor cells.

Diabetes and myopia as risk factors

Depending on the underlying cause, there are different types of retinal detachment:

• In rhegmatogenous retinal detachment, a hole or tear in the retina causes the detachment. Such defects usually occur when the vitreous body, which lines the inside of the eyeball, exerts tension on the retina. Such vitreous detachment is common in older people because the vitreous body shrinks with age. Severe short-sightedness or previous eye surgery for cataracts increases the risk of retinal defects. A blow to the eye can also cause retinal detachment.
• Exudative retinal detachment is caused by fluid accumulation between the retina and the pigment cell layer. This can be caused by inflammation or vascular diseases. In rare cases, retinal detachment is caused by a tumour in the eye, such as choroidal melanoma.
• In a traction retinal detachment, scar tissue pulls on the retina. The reason for scarring of the retina is usually long-term damage from diabetes mellitus (diabetic retinopathy).

Typical symptoms of a retinal detachment

A retinal detachment is usually painless, but there are usually typical symptoms:

• When the vitreous pulls on the retina and tears it, flashes of light often manifest this.
• If the retina is lifted, those affected can perceive this as a shadow or a black curtain that pushes into the field of vision.
• Visual acuity may also be reduced.
• If a retinal tear causes bleeding, a “rain of soot”  can appear in front of the eyes.

Delineate retinal detachment

Individual black dots or “flying gnats” (so-called “mouches volantes”), on the other hand, are usually harmless and can be traced back to a harmless clouding of the vitreous body. However, if they occur for the first time or only one eye is affected, you should consult an ophthalmologist to be safe. The same applies if they occur with other typical signs of retinal detachment.