# Retinal Detachment: Emergency Signs | World Aid Network > Source: https://worldaidnetwork.org/blog/retinal-detachment-uk > Retinal detachment affects 1 in 10,000 people in the UK each year and is a sight-threatening emergency. Learn the warning signs and why 24 hours matters. Direct Answer Retinal detachment is a sight-threatening emergency: go immediately to A&E or eye casualty if you notice a sudden shower of floaters, flashes of light, or a shadow spreading across your vision. Around 1 in 10,000 people in the UK develops one each year. World Aid Network funds eye surgery for poor patients who cannot afford treatment. Retinal detachment is a medical emergency in which the retina — the light-sensitive tissue lining the back of the eye — separates from its underlying support layer, the retinal pigment epithelium. Without prompt surgical treatment, a retinal detachment will cause permanent, irreversible vision loss. Around 1 in 10,000 people in the UK develops a retinal detachment each year. It can happen to anyone, but risk is significantly higher in people with short-sightedness (myopia), those who have had previous eye surgery or eye trauma, and those with a family history of retinal detachment. This guide answers the twenty most commonly searched questions about retinal detachment in the UK, drawing on NHS guidance. ## What are warning signs? The NHS advises going immediately to A&E or an eye casualty department if you experience any of the following: a sudden, dramatic increase in floaters — dark spots, threads, cobwebs or rings floating in your vision; flashes of light (photopsia), particularly in dim conditions or peripheral vision; a dark shadow, curtain or veil appearing at the edge of your vision and spreading inward; a sudden decrease in vision in one eye; or a sense that a section of your visual field is missing. A retinal tear (without detachment) produces similar symptoms — particularly floaters and flashes — and also requires urgent assessment. Laser retinopexy performed promptly for a retinal tear can prevent progression to a full detachment. Never wait to see if symptoms settle — the window for preventing detachment or limiting its extent is narrow. ## What is types of retinal detachment? Rhegmatogenous retinal detachment (RRD) is the most common type — it occurs when a tear or hole in the retina allows liquid vitreous to seep beneath the retina, lifting it away from the RPE. Most retinal tears arise from posterior vitreous detachment (PVD) — the natural age-related separation of the vitreous gel from the retina, which produces the classic floater-and-flash symptoms. The vast majority of retinal detachments in people with no other risk factors are rhegmatogenous. Tractional retinal detachment (TRD) occurs when fibrovascular scar tissue on the retinal surface — most commonly from proliferative diabetic retinopathy — pulls the retina away from the RPE without a retinal break. Exudative (serous) retinal detachment occurs when fluid accumulates beneath the retina due to inflammation, tumour or severe hypertension — without a retinal break. These types are treated differently from RRD. ## What treatment is available? For retinal tears without detachment: laser retinopexy (laser applied around the tear to create a weld) or cryotherapy (freezing probe applied to the sclera adjacent to the tear) seals the tear and prevents detachment. For rhegmatogenous retinal detachment: the primary surgical options are pneumatic retinopexy (a gas bubble is injected into the vitreous to tamponade the tear while the laser weld forms — suitable for superior retinal tears); scleral buckle (a silicone band sutured around the outside of the eye, indenting the sclera to close the tear); or vitrectomy (removal of the vitreous and internal gas/oil tamponade). Vitrectomy is the most commonly performed procedure in the UK for primary RRD — particularly if the macula is already detached. If the macula has not detached ('macula-on' detachment), surgery is performed urgently (within 24 hours) as an emergency to preserve central vision. If the macula is already detached ('macula-off'), surgery is still urgent but the priority is preventing further visual loss rather than restoring normal central vision. ### Key takeaways - Retinal detachment is a sight-threatening emergency. Go immediately to A&E or eye casualty if you experience: a sudden shower of floaters, flashes of light, a shadow or curtain spreading across your vision, or sudden vision loss. - A retinal tear — which produces similar symptoms — can be treated with laser to prevent progression to a full detachment. Never wait to see if symptoms resolve. - 'Macula-on' retinal detachment (central vision not yet affected) requires emergency surgery within 24 hours to preserve central vision. 'Macula-off' detachment has a worse visual prognosis. - Risk is highest in people with myopia (short-sightedness), previous eye surgery, previous retinal detachment, eye trauma and a family history of detachment. - In low-income countries, retinal detachment surgical facilities are absent from most district hospitals. Patients who present with a detachment frequently lose the eye permanently. ## Frequently asked questions What is retinal detachment? Retinal detachment is a serious eye emergency in which the retina — the thin, light-sensitive membrane lining the inside of the back of the eye — separates from the retinal pigment epithelium (RPE), the supportive layer beneath it. Separated from its blood supply, the retina loses function and is at risk of permanent damage. Without prompt surgical treatment, retinal detachment causes irreversible vision loss. What are the symptoms of retinal detachment? Warning symptoms include: a sudden, significant increase in floaters (dark spots, threads, cobwebs or rings drifting across vision); flashes of light (photopsia) in peripheral vision, particularly in dim light; a dark shadow, curtain or veil appearing at the edges of vision and spreading inward; blurred vision in one eye; or a feeling that part of the visual field is missing. These symptoms require immediate attendance at A&E or an eye casualty department — do not wait for a GP appointment. Is retinal detachment an emergency? Yes. Retinal detachment is a medical emergency requiring urgent surgical treatment to prevent permanent vision loss. If the detachment has not reached the macula (the central, high-resolution area of the retina), emergency surgery within 24 hours can preserve central vision — this is a 'macula-on' detachment. Once the macula has detached, central vision loss is likely to be permanent even after successful surgical reattachment. Anyone with sudden floaters, flashes or a visual curtain should go immediately to A&E or their nearest eye casualty unit. What causes retinal detachment? The most common cause is a retinal tear — a break in the retina through which liquid vitreous seeps beneath the retina, lifting it away from its supporting layer. Retinal tears are most commonly caused by posterior vitreous detachment (PVD) — the natural, age-related separation of the vitreous gel from the retina, which produces floaters and flashes. Most PVDs do not cause retinal tears, but people with risk factors (myopia, previous eye surgery) have a higher probability. Less commonly, retinal detachment is caused by diabetic tractional scarring or inflammatory exudation. What are floaters and are they serious? Floaters are dark shapes — spots, threads, rings or cobwebs — that drift across your vision and move as you move your eyes. Most floaters are caused by age-related changes in the vitreous gel (syneresis) and are harmless. However, a sudden onset of multiple new floaters — particularly if accompanied by flashes of light — can indicate a posterior vitreous detachment or, more seriously, a retinal tear or detachment. Any sudden increase in floaters should be assessed urgently by an ophthalmologist or optician the same day. What are the risk factors for retinal detachment? Key risk factors include: myopia (short-sightedness) — even moderate myopia significantly increases risk, and high myopia (over -6 diopters) increases risk substantially; previous retinal detachment in either eye; a family history of retinal detachment; previous cataract surgery (approximately 1–2% of patients develop RRD over time after phacoemulsification); eye trauma or penetrating injury; certain inherited retinal conditions (Marfan syndrome, Stickler syndrome); and lattice degeneration (peripheral retinal thinning) with retinal holes. What is a retinal tear? A retinal tear is a break in the retina that can progress to a detachment if liquid vitreous seeps beneath it. Retinal tears produce the same symptoms as early retinal detachment — floaters and flashes — and require urgent ophthalmological assessment. Most retinal tears are caused by the vitreous gel pulling on the retina as it detaches (posterior vitreous detachment). Treated promptly with laser retinopexy or cryotherapy, the tear can be sealed and detachment prevented. A retinal tear is therefore a warning sign that must not be ignored. How is retinal detachment diagnosed? Retinal detachment is diagnosed by dilated fundus examination — an ophthalmologist examines the retina after dilating the pupil with eye drops, using indirect ophthalmoscopy and slit-lamp biomicroscopy. Ultrasound B-scan is used when the view of the retina is obscured (e.g. by vitreous haemorrhage). OCT may be used to assess macular involvement. Diagnosis requires clinical examination in a hospital or eye casualty unit — it cannot be diagnosed reliably by an optician without specialist equipment and training. What is the treatment for retinal detachment? Treatment depends on the type and extent of detachment. For rhegmatogenous retinal detachment (the most common), options include: vitrectomy (removal of vitreous and internal gas/oil tamponade — most commonly used in the UK); scleral buckle (a silicone band applied to the outside of the eye, indenting the sclera to close the retinal break); and pneumatic retinopexy (an office-based procedure using an injected gas bubble — suitable for specific superior breaks in selected patients). Most patients in the UK are treated with vitrectomy. What is a vitrectomy for retinal detachment? Vitrectomy is a microsurgical procedure performed under local or general anaesthetic in which the vitreous gel is removed from inside the eye using fine instruments inserted through small incisions in the sclera. The detached retina is flattened using perfluorocarbon liquid, laser is applied around all retinal breaks, and the vitreous is replaced with a gas tamponade (SF6 or C3F8) or silicone oil to hold the retina in place while it heals. Gas absorbs spontaneously over weeks; silicone oil requires a second procedure for removal. What is a scleral buckle? A scleral buckle is an external surgical procedure in which a silicone band or sponge is sutured around the outside of the eyeball, indenting (buckling) the sclera inward. This reduces traction on the retinal break and brings the RPE into contact with the detached retina, allowing fluid to reabsorb. It is particularly effective for younger patients with phakic eyes (natural lens intact), inferior detachments and certain types of break. Scleral buckles remain permanently in place and do not require removal. How long does recovery take after retinal detachment surgery? Recovery varies by the surgical technique used and whether the macula was involved. After vitrectomy with gas tamponade, patients must maintain a specific head position (face-down posturing) for up to one to two weeks to keep the gas bubble over the retinal break — this is essential for surgical success but demanding for patients. Vision improves gradually over weeks to months as the retina heals and the gas bubble absorbs. Full recovery of vision — to whatever level is achievable given the extent of detachment and macular involvement — may take three to six months. Can vision be fully restored after retinal detachment? Visual outcomes depend principally on whether the macula was detached before surgery. In 'macula-on' retinal detachment (operated within 24 hours before the macula detaches), the majority of patients recover excellent central vision. In 'macula-off' detachment, the macula has already lost its blood supply; successful surgical reattachment prevents further loss but often leaves permanent central vision impairment — the extent of which depends on how long the macula was detached. Peripheral vision tends to recover better than central vision after macular detachment. Can retinal detachment reoccur after surgery? Yes. Retinal detachment recurrence (re-detachment) occurs in approximately 5–15% of cases following primary vitrectomy, most commonly due to proliferative vitreoretinopathy (PVR) — the formation of scar tissue on the retinal surface that contracts and causes re-detachment. Re-detachment usually occurs within the first few months and requires further surgery. The risk is higher in complex detachments, large or multiple breaks, and cases with existing PVR at the time of surgery. What is posterior vitreous detachment (PVD)? Posterior vitreous detachment (PVD) is the age-related separation of the vitreous gel from the retinal surface. As the vitreous liquefies and shrinks with age, it pulls away from the retina — most commonly in people over 50\. This causes sudden floaters (from vitreous strands collapsing) and flashes of light (from the vitreous tugging on the retina). Most PVDs are harmless, but approximately 10–15% cause a retinal tear. Any PVD symptoms require urgent ophthalmology review to exclude a retinal tear. Who is most likely to get retinal detachment? Retinal detachment can affect anyone, but risk is significantly higher in: people with moderate to high myopia (every 3-diopter increase in myopia raises risk approximately 3-fold); people aged 40–70 (peak incidence as PVD becomes more common); those with a previous retinal detachment (10–15% risk in the fellow eye); people who have had cataract surgery; those with retinal thinning (lattice degeneration); people who have suffered eye trauma; and those with inherited connective tissue disorders (Marfan, Stickler syndrome). Can you prevent retinal detachment? There is no guaranteed way to prevent retinal detachment, but several measures reduce risk. People with high myopia or lattice degeneration should attend regular retinal examinations and report new floaters or flashes immediately rather than waiting. Prophylactic laser retinopexy to seal symptomatic retinal tears or high-risk lattice lesions prevents progression to detachment. Avoiding high-impact head trauma (wearing appropriate protective equipment in contact sports) reduces traumatic retinal detachment risk. All eye symptoms that develop suddenly should be reported promptly. What is the difference between a retinal detachment and a retinal tear? A retinal tear is a full-thickness break in the retinal tissue — the precursor to a retinal detachment. If liquid vitreous passes through the tear and accumulates beneath the retina, the retina begins to separate — this is retinal detachment. A retinal tear without detachment can be sealed with laser or cryotherapy in a clinic, preventing detachment. Once detachment has occurred, surgical intervention (vitrectomy or scleral buckle) in an operating theatre is required. The symptoms of both are similar — floaters and flashes — making urgent assessment critical. What happens if retinal detachment is not treated? Without treatment, a retinal detachment will progressively extend to involve the entire retina, including the macula. Prolonged detachment causes progressive, irreversible damage to photoreceptors and retinal ganglion cells. The longer the detachment is present — particularly if the macula is involved — the worse the visual outcome even after successful surgical reattachment. In some cases, untreated detachment leads to a chronically hypotonic, atrophic eye (phthisis bulbi). Prompt surgery significantly improves the chance of preserving useful vision. How does retinal detachment affect people in developing countries? Retinal detachment surgery — vitrectomy or scleral buckle — requires specialist vitreoretinal surgeons, operating theatre facilities and equipment that are absent from most hospitals in low-income countries. Patients who present with a retinal detachment to a district hospital are typically referred on — often travelling long distances — only to find the wait too long or the service unavailable. The result is permanent blindness from a condition that is eminently treatable with timely surgery. World Aid Network funds eye care through locally-licensed ophthalmologists. [**Medically reviewed by Mr Mohamed Mohyudin**MBChB BSc MSc FRCOphth CCT · GMC No. 7039600 · Consultant Ophthalmic Surgeon](https://mohamedmohyudin.co.uk/) This article was reviewed by the World Aid Network editorial team for factual accuracy against WHO, NHS, HMRC and Charity Commission sources. World Aid Network is a UK Charitable Incorporated Organisation (charity registration in progress), governed by named trustees. ### Help bring sight-saving eye surgery to those who cannot afford it Retinal detachment surgery requires specialist facilities unavailable in most low-income country hospitals. Patients who should be cured in hours lose their sight permanently because the care is simply not there. World Aid Network funds eye surgery through locally-licensed ophthalmologists. [Donate Now](/donate)[View the Gift of Sight Appeal](/appeal/gift-of-sight)[Eye charity programmes](/blindness-charity) Charitable Incorporated Organisation Funds restricted to our charitable Objects Gift Aid will apply for UK taxpayers once registration is complete --- World Aid Network is a UK Charitable Incorporated Organisation (charity registration in progress; application ref 5290505, ICO ref ZC156579).