The natural history of asymptomatic retinal breaks.

A long-term prospective follow-up of 359 asymptomatic retinal breaks, involving 231 eyes of 196 patients, was carried out for from one to 18 years, without treatment. This group was drawn from a consecutive series of phakic eyes of patients who had not had retinal detachment. Fifty of the breaks were tractional tears with attached flaps. No case of clinical retinal detachment occurred. Eighteen separate small subclinical retinal detachments occurred, involving 17 eyes, but only three of these enlarged slightly. No case in the series was treated. The absence of clinical retinal detachment in this series argues strongly for the relative safety of asymptomatic retinal breaks in phakic, nonfellow eyes, even if they are tears with attached flap in superior locations. Prophylactic treatment is not justified for this type of break in this type of eye.