Many people see small black dots or “flying gnats” when looking up at the sky or at a white surface. This is usually a sign of a harmless clouding of the vitreous in the eye. However, if whole “swarms” of gnats or flashes suddenly appear, this may indicate a retinal detachment. Then you should immediately consult an ophthalmologist, 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 what the causes may be.
Retinal detachment: ophthalmologic emergency
In a retinal detachment (technically called an ablatio retinae or amotio retinae), the top layer of the retina detaches from the underlying pigment cell layer. The areas of the detached retina can then no longer be adequately supplied with blood, since there is no contact with the blood vessels that run beneath the pigment cell layer. This results in the death of photoreceptors.
If the retina is affected in the area of the yellow spot – the point of sharpest vision – this can lead to a reduction in visual acuity and even blindness. Therefore, if you experience symptoms of retinal detachment, you should see an ophthalmologist as soon as possible, or the emergency ophthalmology service on weekends.
Diabetes and myopia as risk factors
Depending on the underlying cause, there are different forms of retinal detachment:
- In rhegmatogenous retinal detachment, a hole or tear in the retina causes detachment. Such defects usually occur when the vitreous, which lines the inside of the eyeball, exerts traction on the retina. Such vitreous detachment is common in older people because the vitreous shrinks with age. Severe nearsightedness or previous eye surgery for cataracts also increase the risk of retinal defects. In addition, a blow to the eye can lead to retinal detachment.
- Exudative retinal detachment is caused by an accumulation of fluid between the retina and pigment cell layer. Causes may include inflammation or vascular disease. In rare cases, this form of retinal detachment is caused by a tumor in the eye, such as choroidal melanoma.
- In tractional retinal detachment, scar tissue exerts traction on the retina. The reason for scarring of the retina is usually long-term damage from diabetes mellitus (diabetic retinopathy).
Typical symptoms of retinal detachment
Retinal detachment is usually painless, but typical symptoms usually occur:
- When the vitreous pulls and tears the retina, it is often manifested by flashes of light.
- If the retina lifts, affected individuals may perceive this as a shadow or black curtain pushing into the visual field.
- Visual acuity may also be reduced.
- If a hemorrhage occurs due to a retinal tear, a “sooty rain” may appear before the eyes.
Delineate retinal detachment
Single black dots or “flying gnats” (so-called “mouches volantes“), on the other hand, are usually harmless and due to a harmless vitreous opacity. However, if they occur for the first time or if only one eye is affected, you should consult an ophthalmologist to be on the safe side. The same applies if they occur in combination with other typical signs of retinal detachment.
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