Current opinion on treatment of asymptomatic retinal detachments

To determine the current opinion of vitreoretinal consultants in the UK on the treatment of asymptomatic retinal detachments.

A questionnaire survey of UK and Eire vitreoretinal consultants on recommended therapy for eight different case scenarios of asymptomatic retinal detachment.

A questionnaire was sent to 115 consultants in UK and Eire. Fifty-four per cent were returned. The majority of surgeons favoured active intervention for most types of asymptomatic retinal detachment, with surgery being the most popular. Laser demarcation of the detached retina was the second most favoured approach followed by observation alone. Discharge with advice to seek attention if symptoms appeared was the least frequently recommended. Recommended management varied considerably for each scenario. The presence or absence of a demarcation line had the greatest influence on the management of each case. Age of patient had a much smaller effect, and degree of myopia had very little effect.

Surgery remains the most common recommended management for an asymptomatic retinal detachment. The striking outcome of the survey is the variability in responses for any given scenario, ranging from surgical intervention to the patient being discharged with advice. This reflects the absence of hard clinical evidence to support any particular management option in such cases. As patient involvement in decision making over management is essential, the opinions expressed in this survey may not be a true reflection of actual practice, although it does highlight the need for further research in this field to provide guidance for treatment of this important condition.