A 68-year-old man presents with sudden onset of a curtain coming down from above in his right eye, preceded by a shower of floaters and photopsia. Fundoscopy reveals an elevated, grey, billowing retina with a horseshoe tear at 11 o'clock position. The appropriate surgical management is:

• A Intravitreal anti-VEGF injection
• B Pneumatic retinopexy or scleral buckling ✓
• C Nd:YAG laser capsulotomy
• D Panretinal photocoagulation

Explanation

This presentation is consistent with a rhegmatogenous retinal detachment (RRD) caused by a horseshoe (U-shaped) tear, the most common type of RRD. Treatment options include pneumatic retinopexy (injecting an expansile gas bubble to close the tear), scleral buckling (indenting the sclera to relieve vitreoretinal traction), or pars plana vitrectomy, depending on the tear location and surgeon preference. Prompt intervention is critical, especially if the macula is not yet detached, to preserve central vision.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.