Symptoms:
Acute retinal break: flashes of light, floaters (“flies”), blurred vision
Chronic retinal breaks and atrophic retinal holes: usually asymptomatic

Clinical signs
Slit-lamp:
1. Pigmented cells in the anterior vitreous
2. Vitreous haemorrhage
3. Posterior vitreous detachments (discrete light gray vitreous opacities, often in the shape of a ring “Weiss ring”), suspended over the optic disc)

Ophthalmoscopy:

1. A full thickness retinal defect (usually seen in the periphery)
2. Operculum (free-floating piece of retina) suspended in the vitreous cavity above the retinal hole
3. In chronic retinal break
A. a ring of pigmentation surrounding break
B. Demarcation line between attached and detached retina

Predisposing conditions:

1. lattice degeneration
2. high myopia
3. history of previous retinal break or detachment
4. aphakia
5. pseudophakia
6. age-related retinoschisis
7. trauma

Management

1. Dilated fundus examination of both eyes by indirect ophthalmoscopy
2. A slit lamp examination with fundus contact lens
3. Treatment must be individualised (laser, cryotherapy, scleral buckling surgery)
4. Follow up after treatment of retinal break -1 week, 1 month, 3 months, every 6 to 12 months
5. Follow up with predisposing lesions that do not require treatment –every 6 to 12 months