Posterior Segment
Retinal Tear
Also known as: retinal tear, retinal break, horseshoe tear, operculated hole, lattice degeneration, peripheral retinal tear, laser retinopexy, flashes and floaters with 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
A full-thickness break in the neurosensory retina, typically horseshoe or operculated and most often superotemporal, allowing fluid access to the subretinal space. Presents with acute new floaters and peripheral photopsia; pigment or blood in the anterior vitreous raises concern for a break. Same-day retinal referral is indicated for specialist laser retinopexy or cryotherapy, ahead of any accumulation of subretinal fluid.
Recognition
Symptoms: what patients report
- Acute onset of new floaters — often sudden increase or a shower.
- Photopsia — flashing lights in the peripheral visual field.
- Possible reduction in peripheral visual field if subretinal fluid has begun to accumulate.
- Visual acuity may be preserved if the macula is not involved.
- A curtain or shadow encroaching on central vision indicates retinal detachment — emergency.
Signs: what the examination shows
- Retinal tear visible on dilated indirect ophthalmoscopy or slit lamp with 3-mirror lens — typically horseshoe or operculated morphology.
- Associated subretinal fluid may be present around the tear.
- Shafer's sign / tobacco dust, vitreous haemorrhage, or red/black floaters — pigment or blood in the vitreous is highly suggestive of retinal break and supports urgent retinal assessment.
- The tear is most commonly in the superotemporal quadrant.
- Lattice degeneration or other peripheral retinal degeneration may be present.
What OptoGuide™ covers for 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
Sources
Standard texts: Kanski's Clinical Ophthalmology: A Systematic Approach, The Wills Eye Manual, Oxford Handbook of Ophthalmology, Oxford American Handbook of Ophthalmology, Signs in Ophthalmology: Causes & Differential Diagnosis.