If you cut your finger or twist your ankle, it hurts. But when something bad happens to one of your retinas, the light-sensitive tissue at the back of your eyes, you feel no pain. Your retina, the part of your eye that sends visual information to the brain, can be torn or even detached from its blood supply without causing you a bit of discomfort.
But no pain doesn’t mean no symptoms. In fact, eye doctors say, there are clear warning signs that everyone should know. That’s because, “generally, the sooner the patient is diagnosed and treated, the better the outcome,” says Purnima Patel, an associate professor of ophthalmology at the Atlanta Veterans Affairs Medical Center and a spokesperson for the American Academy of Ophthalmology. Over a lifetime, about 3 in 100 people will experience a detached retina. That makes it much less common than major causes of vision loss, such as glaucoma and cataracts. But the consequences can be serious. When the retina peels off the back of your eye — like wallpaper sloughing off the wall of a steamy bathroom — it can’t do its job. Left untreated, a detachment can cause permanent vision loss or blindness in the affected eye. The most common kinds of detachments happen after a tear develops in the tissue-thin retina, allowing fluid to seep behind the retina and loosen it. Retinal tears most often are triggered, in susceptible people, by what start out as normal changes in the aging eye.
The most important changes to watch for:
1. Lots of new floaters
Floaters are specks that seem to appear before your eyes but really come from inside your eyes. They “can look like spider webs, or bugs floating in your vision, or just like a little bit of a dark swirl,” Patel says.
The specks tend to be more noticeable in bright light, especially when you look at a white background, says Philip Ferrone, president of the American Society of Retina Specialists and a professor of ophthalmology at Hofstra University. Floaters you’ve had for a while generally aren’t cause for concern. But anytime a new crop suddenly appears, you should pay attention, Patel and Ferrone say. Floaters often are caused by age-related changes in the ball of gel that fills the space between the lens near the front of your eye and the retina in the back. This gel ball, called the vitreous, shrinks and becomes more liquefied as you age, creating blobs and strands picked up in your vision. Typically, around age 60 or so, the vitreous pulls away from the retina, Ferrone says. That separation, called a posterior vitreous detachment, can cause a small amount of bleeding and a sudden increase in floaters, he says.