This patient presented with a giant retinal tear. Against medical advice, the patient adamantly refused vitrectomy on multiple occasions, so we decided to demarcate it with laser photocoagulation. As expected, the detachment progressed through the laser scarring with the development of proliferative vitreoretinopathy. He subsequently needed several vitrectomy procedures, including retinectomy and silicone oil to obtain final retinal reattachment.
Learning Points:
Untreated retinal tears have a very high risk for progressing to retinal detachment. Urgent laser photocoagulation or cryotherapy prevents liquid vitreous from leaking thru the break. Patients need to be followed closely postoperatively to be sure no new breaks develop and that chorioretinal scarring surrounds the break.
