The people most at risk for retinal detachment are those over 50, people with significant nearsightedness, anyone who has had eye surgery (especially cataract removal), and those with a family history of the condition or certain genetic syndromes. Your risk rises further if you’ve already had a detachment in one eye. While retinal detachment can happen to anyone, most cases cluster around a few well-established factors, and understanding where you fall can help you recognize warning signs early.
Age Is the Biggest Factor
Retinal detachment peaks in the sixth and seventh decades of life, roughly between ages 50 and 70. The reason is straightforward: as you age, the gel-like substance filling the inside of your eye gradually shrinks and pulls away from the retina. This process, called posterior vitreous detachment, happens to most people eventually and is usually harmless. But in some cases, the pulling creates a tear in the retina, and fluid seeps behind it, lifting it away from the back wall of the eye.
This age-related pulling is the most common cause of what’s called rhegmatogenous retinal detachment, which is by far the most frequent type. If you’re experiencing new floaters, flashes of light, or a shadow creeping across your vision, the first six weeks after symptoms start is the critical window when a vitreous detachment is most likely to progress into a retinal tear.
Nearsightedness Multiplies Your Risk
Nearsightedness, or myopia, is one of the strongest risk factors outside of age. The more nearsighted you are, the higher your risk. This is because highly myopic eyes are physically longer than average, which stretches the retina thinner and makes it more vulnerable to tears.
The numbers are striking. For people with mild to moderate nearsightedness (up to about -4.75 diopters), the yearly incidence of retinal detachment is roughly 0.015%. At -5.00 to -9.75 diopters, that jumps to 0.07%. And at prescriptions stronger than -10.00 diopters, the rate climbs to about 0.075% per year. Over a lifetime, roughly 3.2% of people with high myopia (beyond -6.00 diopters) will experience a detachment, compared to 0.71% of people with normal vision. At the extreme end, those with -15.00 to -20.00 diopters of myopia face a risk 15 to 110 times greater than someone without a refractive error.
High myopia is generally defined as an eye with a prescription of -6.00 diopters or stronger, which corresponds to an eyeball length greater than 26 millimeters. If your glasses or contact lens prescription falls in this range, regular dilated eye exams are especially important.
Previous Eye Surgery, Especially Cataract Removal
Cataract surgery is one of the most common operations in the world, and while it’s very safe overall, it does increase the chance of a later retinal detachment. A large meta-analysis found that the risk of detachment within roughly four years of cataract surgery is slightly less than 1 in 100. For refractive lens exchange, a similar procedure done to correct vision rather than remove a cataract, the risk is higher: about 1 in 50 over the same timeframe.
The risk is thought to increase because removing the natural lens changes the internal dynamics of the eye, which can accelerate the vitreous pulling away from the retina. People who were already highly nearsighted before cataract surgery carry a compounded risk, since both factors apply.
A Detachment in One Eye Raises Risk in the Other
If you’ve already had a retinal detachment in one eye, the other eye deserves close monitoring. Most estimates put the risk of a detachment in the fellow eye at around 10%, though published figures range from 5% to as high as 34% depending on the study population. One large dataset tracking over 5,200 patients who had surgery for a detachment in one eye found that about 5% eventually needed the same operation on the other side.
The wide range in estimates reflects differences in follow-up time and underlying risk factors. Someone whose first detachment was caused by severe myopia or a genetic condition is more likely to develop a second than someone whose detachment followed isolated trauma.
Genetic and Connective Tissue Conditions
Certain inherited conditions make the retina structurally fragile from a young age. Stickler syndrome is the leading cause of hereditary retinal detachment in children. It affects connective tissue throughout the body, causing problems with the eyes, joints, hearing, and facial structure. It’s uncommon, affecting roughly 11 to 13 per 100,000 people, but carries a disproportionately high risk of detachment, particularly in those with changes to the gel inside the eye and thinning of the peripheral retina.
Genetic testing in Stickler syndrome patients most often identifies variants in the COL2A1 gene (found in about 45% of tested patients), and those with this specific variant, along with pre-existing changes to the vitreous and areas of retinal thinning called lattice degeneration, appear to face the highest risk. Wagner syndrome, caused by a different gene, shares overlapping eye features with Stickler syndrome and also carries elevated detachment risk. Marfan syndrome, another connective tissue disorder, is similarly associated with eye complications including retinal detachment.
Lattice Degeneration and Other Retinal Thinning
Lattice degeneration is a condition where patches of the peripheral retina become abnormally thin. It’s fairly common, found in roughly 6% to 8% of the general population, and most people with it never develop problems. A long-term study tracking 276 patients with lattice degeneration found that only about 1% eventually developed a clinical retinal detachment. Still, the condition is worth knowing about because it shows up frequently in people who do experience detachments, and it’s something your eye doctor may note during a routine dilated exam.
The presence of lattice degeneration matters most when it’s combined with other risk factors. A highly myopic person with lattice degeneration, for example, carries more risk than someone with lattice degeneration alone.
Eye Injuries and Trauma
A hard blow to the eye or head can cause a retinal detachment immediately or months to years later. This is called traumatic retinal detachment and can happen at any age. Sports injuries, car accidents, falls, and workplace accidents involving projectiles are common causes. Unlike age-related detachments, traumatic cases often affect younger people who have no other risk factors. If you’ve ever had a significant eye injury, that eye remains at elevated risk indefinitely.
Diabetic Eye Disease
People with advanced diabetes can develop a different type of retinal detachment called tractional detachment. This happens when abnormal blood vessels grow on the retina’s surface (a complication of poorly controlled blood sugar over time) and form scar tissue. As the scar tissue contracts, it physically pulls the retina away from the back of the eye. Unlike the tear-based detachments described above, tractional detachments don’t start with a hole in the retina. They’re most common in people with proliferative diabetic retinopathy, the most advanced stage of diabetic eye disease.
How Multiple Risk Factors Compound
Retinal detachment risk doesn’t just add up. It multiplies. A 60-year-old with high myopia who has had cataract surgery is in a very different risk category than a 60-year-old with perfect vision and no surgical history. Similarly, a young adult with Stickler syndrome, lattice degeneration, and a family history of detachment needs a more aggressive monitoring schedule than someone with just one of those factors.
Knowing your risk profile helps you respond appropriately to warning signs. A sudden increase in floaters, flashes of light (especially in your peripheral vision), or a curtain-like shadow across part of your visual field all warrant urgent evaluation. In people with multiple risk factors, these symptoms should be treated as time-sensitive, since early treatment of a retinal tear can often prevent a full detachment.