This 70YO female was examined for new flashes and floaters in her right eye and was found to have a retinal tear with localized subretinal fluid at the superonasal equator.
Several nearly confluent rows of laser photocoagulation were applied along its posterior and lateral edges, but we could not extend treatment around its anterior margins with the available slit lamp delivery.
The patient returned the following day to another office where we have our cryotherapy device, where the remainder of the break and fluid were administered.
Learning Points:
Symptomatic retinal tears in the presence of an acute posterior vitreous detachment have a high risk of causing a rhegmatogenous retinal detachment. Prophylactic retinopexy is therefore indicated. Treatment must completely surround the tear and, ideally, extend to the ora serrata. Both thermal laser photocoagulation and cryotherapy are equally effective in creating a vitreoretinal adhesion, which takes at least several weeks to form.
