This 64YO male presented with acute flashes and floaters in his right eye. Optos imaging shows a patch of pigmented lattice superotemporally, associated with a retinal tear and atrophic hole. The breaks were surrounded with laser photocoagulation.
Learning Points:
Retinal detachment occurs in 1 in 10,000 people per year. Lattice is found in 10% of the general population, especially in high myopes. Since about one-third of patients with retinal detachment have lattice as the cause, the question always arises: Should prophylactic retinopexy be performed?
The short answer is that asymptomatic lattice generally should not be treated. However, an eye with symptomatic lattice breaks, as in our patient, is at high risk for developing rhegmatogenous detachment and should always be treated.
Excellent references on this controversial topic include: Byer Ophthalmology 1989;96:1396-1402, Folk et al Ophthalmology 1989;96:72-79 and Folk et al Retina 1990;10:165-169.
