A 45-year-old highly myopic patient develops sudden floaters and a peripheral horseshoe retinal tear without subretinal fluid on slit-lamp biomicroscopy. The appropriate management is:

• A Immediate pars plana vitrectomy with tamponade
• B Scleral buckling procedure
• C Observation with weekly fundus exams for 4 weeks
• D Urgent laser photocoagulation or cryopexy to the tear ✓

Explanation

A symptomatic horseshoe (flap) retinal tear without subretinal fluid (no detachment yet) is a prophylactic treatment indication because it carries approximately 30-50% risk of progression to rhegmatogenous retinal detachment. Urgent laser photocoagulation (2-3 rows surrounding the tear) or cryopexy creates a chorioretinal adhesion that walls off the break. Scleral buckle or vitrectomy are appropriate for frank retinal detachments, not isolated tears. Observation is inappropriate for symptomatic horseshoe tears since the vitreous traction is active.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.