Posterior Segment
Retinal Dialysis and Giant Retinal Tear
Also known as: retinal dialysis, dialysis at the ora serrata, giant retinal tear, GRT, traumatic retinal break, traumatic retinal detachment, blunt trauma retina, Stickler syndrome retinal tear
Filed as: Emergency
Source-cited from the record's own evidence list. Clinical content programme led by Dr Ankit Mathur, PhD, Grad Cert Ocu Thera, B.S. Optom. How the clinical content is governed
Clinical decision support only
Overview
Two large circumferential full-thickness retinal breaks. A retinal dialysis is a break at the ora serrata, typically after blunt trauma in a young male, and it can present weeks or months later with a shallow, slowly progressing detachment. A giant retinal tear extends over at least 3 clock hours in an eye with a posterior vitreous detachment; most are idiopathic, with associations including trauma, previous intraocular surgery, high myopia and Stickler syndrome. Both carry a high risk of detachment and need urgent same-day referral to a vitreoretinal service. The fellow eye of a giant retinal tear needs regular dilated examination.
Recognition
Symptoms: what patients report
- Giant retinal tear: sudden floaters, flashes and a rapidly spreading shadow or loss of vision.
- Retinal dialysis: often few or no symptoms at first; a slowly enlarging field defect or blur weeks to months after a blunt injury.
- A history of blunt trauma, sometimes minor and half-forgotten.
- Central vision falls when the macula detaches.
Signs: what the examination shows
- Retinal dialysis: a full-thickness break at the ora serrata, running circumferentially; scleral indentation may be needed to see it.
- A shallow detachment behind a dialysis, sometimes with demarcation lines or cysts that indicate chronicity.
- Giant retinal tear: a circumferential full-thickness break over at least 3 clock hours with a posterior vitreous detachment.
- Pigment cells in the anterior vitreous; vitreous haemorrhage may be present.
- Giant retinal tear: examine the fellow eye dilated; it has an increased risk of detachment.
What OptoGuide™ covers for retinal dialysis and giant retinal tear
- Pattern reasoning: what this combination of findings points to, and its differentiators
- Don't-miss risks and escalation triggers
- Management tiers with linked Australian therapeutics
- Referral urgency, specialty, and letter drafting