Choroidal detachment associated with retinal detachment as a presenting finding

Choroidal detachment along with retinal detachment as a presenting finding is rare. We identified five such cases presenting to our ophthalmology practice between 1964 and 1991. The patient is usually myopic and presents with marked visual loss, profound hypotony and a marked anterior chamber reaction. The pathogenesis seems to revolve around the hypotony and myopia and an unstable choroidal vascular system. Management usually involves a scleral buckling procedure with cryotherapy under direct visualization to release choroidal and subretinal fluid, possibly preceded by a few days of anti-inflammatory therapy. The overall prognosis is poor owing to delays in diagnosis and the postoperative development of proliferative vitreoretinopathy.