When to refer retinal tear
Structured for Australian optometry practice.
Clinical decision support only
OptoGuide™ supports professional judgement and does not diagnose or replace clinician responsibility.
Quick answer
- Retinal tear referral is usually driven by new flashes, floaters, field symptoms, vitreous pigment, or a limited peripheral retinal view.
- A new symptomatic PVD is not automatically benign until the peripheral retina is confidently assessed.
- Shafer sign, haemorrhage, or suspicious peripheral changes should trigger same-day escalation.
- Do not delay referral when symptoms are new and the retina cannot be fully examined.
Common causes
- Acute posterior vitreous detachment with or without break formation.
- Retinal tear associated with high myopia or lattice degeneration.
- Trauma-related peripheral retinal break.
- Vitreous traction with haemorrhage.
Red flags (must not miss)
- New flashes with a shower of floaters.
- Curtain, veil, or field loss.
- Shafer sign or vitreous haemorrhage.
- Peripheral retinal hole, flap tear, or suspicious traction.
- Inadequate peripheral retinal view.
Use OptoGuide™ to guide this decision during consult.
What to check
- Symptom onset, progression, and any field loss.
- Dilated peripheral retinal assessment.
- Vitreous pigment, haemorrhage, or posterior vitreous separation signs.
- Myopia, trauma, and retinal history.
- Whether the view is complete enough to exclude a tear confidently.
When to refer
- Same day for suspected tear, detachment, vitreous haemorrhage, or field defect.
- Urgent retinal review when symptoms are new but the peripheral retina is not fully assessed.
- Routine follow-up only after a confident benign dilated assessment.
Initial management
- Treat symptomatic retinal break risk as time-sensitive until excluded.
- Document symptoms, retinal view quality, and peripheral findings clearly.
- Give strict return advice if the initial assessment is benign.
Clinical basis
This guidance reflects standard optometric clinical reasoning based on:
- Australian optometry clinical practice patterns
- Australian medicines regulation and PBS prescribing context
- Common ophthalmology referral standards
- Evidence-based clinical training and practice
Use OptoGuide™ during consult for structured clinical guidance.