What are the key symptoms and signs that indicate a patient may have a retinal detachment?

Key symptoms indicating possible retinal detachment include:

• New-onset flashes of light in the vision.
• New floaters appearing in the visual field.
• Visual field loss or defects, such as shadows or curtain-like obscuration.
• Changes or reduction in visual acuity.
• A sudden onset of these symptoms, often progressing over 1–3 days.

Key signs that suggest retinal detachment on examination include:

• Fundoscopic evidence of retinal detachment or vitreous haemorrhage.
• Presence of pigment cells within the vitreous.
• Signs of vitreous haemorrhage or retinal breaks identified by slit lamp examination and indirect ophthalmoscopy.

Because retinal detachment cannot be reliably excluded by symptoms alone or by direct ophthalmoscopy in primary care, urgent referral for specialist dilated fundoscopy and indirect ophthalmoscopy is essential when these symptoms or signs are present to confirm diagnosis and initiate timely treatment.

Early detection before macular involvement is critical to preserve central vision and improve surgical outcomes.

Patients should also be advised about the importance of immediate ophthalmology assessment if they experience these symptoms, and about protective measures such as wearing eye protection during at-risk sports to reduce trauma-related risk.

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