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LETTER TO EDITOR
Year : 2006  |  Volume : 54  |  Issue : 1  |  Page : 67

Spontaneous bilateral giant retinal tears with near simultaneous occurrence.


D - 66, Malcha Marg, Chanakyapuri, New Delhi - 110021, India

Correspondence Address:
Atul Kumar
D - 66, Malcha Marg, Chanakyapuri, New Delhi - 110021
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.21627

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How to cite this article:
Kumar A, Prakash G, Gupta R. Spontaneous bilateral giant retinal tears with near simultaneous occurrence. Indian J Ophthalmol 2006;54:67

How to cite this URL:
Kumar A, Prakash G, Gupta R. Spontaneous bilateral giant retinal tears with near simultaneous occurrence. Indian J Ophthalmol [serial online] 2006 [cited 2019 Dec 10];54:67. Available from: http://www.ijo.in/text.asp?2006/54/1/67/21627

Dear Editor,

Giant retinal tears (GRT) may have many causes such as high myopia (>10 D), trauma, following surgery-induced in various syndromes like Stickler's etc. Bilaterality, though reported after LASIK[1] and on longer follow-up[2], has never been reported to be simultaneous. We herein report a case of simultaneous presentation with idiopathic bilateral giant retinal tear and retinal detachment.

A 54-year-old male patient was referred to our centre with history of sudden diminution of vision in left eye for past 36 hours. He had a vision of 20/30 in right eye and hand movement vision in left eye. The lens was clear in both eyes and was using 2.5D and 3.5D of minus power lenses in right and left eyes respectively. He did not give any history of any intraocular surgery or significant trauma. He was diagnosed as a case of left eye temporal 180 GRT with total retinal detachment with right eye normal retinal periphery. He was posted for surgery next day. But in the evening of the same day he complained of sudden diminution of vision in right eye also. The vision had dropped from 20/30 to 10/200 within 8 hours of his first contact with us. Examination revealed nasal 180 GRT with detachment. It was then planned to operate on his right eye first and then left eye. He underwent vitreous surgery with 360 buckle with endolaser and silicone oil tamponade in the right eye and three days later in the left eye.

The patient gained best-corrected visual acuity of 20/30 in the right eye and 20/120 in the left eye at 14 days' follow-up. Intraocular pressure was normal and the lens remained clear in both the eyes. We removed the silicone oil 3 months postoperatively, the best corrected vision was maintained at 20/30 in the right eye while it was 20/200 in the left eye. He was on regular follow-up (last being on November 9th, 2005) since then.

We report this case to highlight that idiopathic bilateral, spontaneous, simultaneous GRT can occur in otherwise healthy eyes of phakic patients with mild to moderate myopia. Cases of GRT (even though fellow eye shows no signs of peripheral retinal complications) should be kept on regular follow up for the fellow eye even after the involved eye is operated upon successfully as GRT might develop anytime during the course. This can happen as early as within 2 days of initial presentation with GRT. Timely diagnosis and early surgery is the key to success and the operation should be done on an emergency basis. Follow-up for fellow eye should be done even if the patient is not a high myope, no severe peripheral white-without-pressure is seen or extensive vitreous degeneration is present. In conclusion, the possibility that myopia caused the GRT cannot be completely excluded, but this case represents a rare report of spontaneous bilateral GRT with near simultaneous occurrence.

 
  References Top

1.
Ozdamar A, Aras C, Sener B, Oncel M, Karacorlu M. Bilateral retinal detachment associated with giant retinal tear after laser-assisted in situ keratomileusis. Retina 1998;18:176-7  Back to cited text no. 1
[PUBMED]  [FULLTEXT]  
2.
Freeman HM. Fellow eyes of giant retinal breaks. Trans Am Ophthalmol Soc 1978;76:343-82.  Back to cited text no. 2
[PUBMED]  [FULLTEXT]  



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