Spontaneous bilateral giant tears of the retinal pigment epithelium

In 1981, Hoskin et al 1 described retinal pigment epithelial tears as a newly recognised severe complication of pigment epithelial detachment. Retinal pigment epithelial tears, which may occur either spontaneously or after laser photocoagulation to treat pigment epithelial detachment and choroidal neovascularisation (CNV) in diseases such as age related macular degeneration (AMD), usually cause sudden visual loss at the time of tearing. We report a case of spontaneous bilateral giant tears of the retinal pigment epithelium (RPE). A 79 year old woman was referred on 18 January 2002, because of sudden visual loss in the left eye of 2 weeks’ duration. In October 2001, the patient had undergone bilateral phacoemulsification and lens implantation by her local ophthalmologist. She had no apparent complications postoperatively, and the postoperative visual acuity (VA) was 20/250 in the right eye and 20/20 in the left eye; however, she noticed sudden decreased vision in the left eye on 3 January 2002, and visited the local ophthalmologist 5 days later. When she presented to our hospital, her VA was 20/200 in right eye and hand movements in the left eye. The intraocular pressure was 18 mm Hg in the right eye and 19 mm Hg in the left eye. The external eye examination, pupillary responses, and results …