A high myope presents with a flap (horseshoe) tear at the posterior edge of a vitreous syneresis zone. Immediate treatment with barrier laser photocoagulation around the tear is indicated because:

• A It reduces IOP spikes associated with PVD
• B It reduces subsequent vitreous hemorrhage from the torn retinal vessels
• C It prevents proliferative vitreoretinopathy (PVR) formation
• D It creates a chorioretinal adhesion that prevents liquid vitreous from passing under the retina through the break, preventing progression to rhegmatogenous RD ✓

Explanation

Laser demarcation (barrier laser) applied around a symptomatic retinal break creates a chorioretinal adhesion scar encircling the tear. This adhesion barrier prevents liquid vitreous from seeping beneath the neurosensory retina through the break, which would otherwise cause a rhegmatogenous retinal detachment. Flap tears associated with acute PVD and symptoms (floaters, photopsia) have a significant risk (up to 50%) of progressing to RD without treatment.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.