IV. BEFORE RETINA SURGERY IS UNDERTAKEN

The first key to successful surgery is to find all the tears in the retina. For an optimal retina examination, the patient lies down and the ophthalmologist views the retina with a head mounted indirect ophthalmoscope, holding a special lens in one hand and an indenting device or "depressor" in the other (Fig. 4). The "depressor" is to indent the eye in its anterior portion so the thin peripheral retina (where small retinal tears may lie hidden) can be thoroughly examined. The process may be somewhat uncomfortable and last up to a half hour, but it is the most important for surgical success. The treatment rests primarily on the findings made in the preoperative examination. The size, number and location of the retinal tears, the extent of the retinal detachment, plus evidence of internal vitreous traction determine the course of treatment.

Laser and cryotherapy (freezing) may be sufficient if the retina is flat around the retinal tears. This permits an adhesive scar to surround the tears. The scar so created prevents the development of a retinal detachment.