Kanski in his textbook diagram describes "large retinal tears" as candidates for treatment. These tears cover a third of the quadrant length (temporal). But, given that we know that only 1 out of 3 tears results in an amotio, R. (Gupta et. al, Bri. Journal. Opth), with a tear less than 1/8 quadrant size, (resulting from PVD), + Shaffer sign, + no liquid inside the borders, how would you treat yourself ? (With a patient, you might go the 'safe' route. But, one needs to recall that the Laser for the oncoming week does not really alter the situation, the bonding happens afterward, and the treatment itself will leave the typical tiny peripheral "dark spot", and is unpleasant.

What would you do if you were presenting with the tear, with full info based on retinal image ? (PVD uneventful, light floater, Weiss, very minor flashing only on extreme eye movement), second eye to have PVD, no familial history, no trauma, but myope, phakic.)

Thanks for the input here, you may once be confronted with this yourself...
Cheers,
Mike

Any symptomatic horseshoe tear should be treated regardless of location, extent, presence or absence of subretinal fluid, or a prior tear/RD in the fellow eye. I would absolutely want a laser retinopexy or cryo for myself or a family member and this is the standard of care. The resulting scar would be very unlikely to produce a noticeable peripheral scotoma, and I have never heard a patient complain of this.

Thx for the reply. On page 736 he shows diagram of the various tears,
and in the upper quadrants, he shows two, one "large" , and the other
one "operculated, but with a bloodvessel crossing it". (Also a theraphy candidate.)

If "any" horseshoe is a candidate, why "A LARGE horseshoe tear...should be treated immediately.

Now, on the other hand, he does not discuss smaller ones, except inferior, and asymptomatic holes (round).

He does state that there is a relation between size and risk, and symptomaticness.

In other words, I was looking for the phrase: Any, even small, horseshoe tears, when superior, following PVD should receive therapy. But this he does not say. Is this clearer in other textbooks ?