Purpose To report the management of giant retinal tears (GRT). Methods Retrospective review of all patients who underwent surgery for GRT with at least 6 months follow-up. Results A total of 124 patients with 128 eyes were managed for GRT between 1991 and 2005. Of them, 99 eyes of 96 patients with at least 6 months follow-up were reviewed (mean follow-up 63.38 months). There were 113 men and the mean age was 39.6 years (8-72 years). Myopia was present in 81 eyes (63.3%) with mean myopia À7.56 dioptres sphere, DS (À1.00 to À27.00 DS). All eyes underwent pars plana vitrectomy. Scleral buckling was done in 90 eyes (70.3%) and lens removal in 49 of 95 phakic eyes (51.2%). Total 84 eyes (84.8%) were re-attached at 6 months after vitrectomy. This was achieved with one surgery in 71 eyes (71.7%). The mean number of surgeries for reattachment was 1.19 surgeries. At 6 months, 41 eyes (41.4%) regained 20/40 or better vision. A total of 47 vitreoretinal pathologies were seen in the fellow eyes of the 124 patients, including 4 with GRTs. Conclusion Surgical success for GRT can be achieved with good visual outcome in 84.8% after a mean of 1.19 surgeries. The fellow eyes are however at risk of pathologies and should be followed-up in the long term.

patient with high BP and unilateral acute-angle closure glaucoma without any other end-organ damage. Case reportA 22-year-old man presented with severe pain in the left eye without any significant past ocular history. The right eye examination was within normal limits and the left eye had visual acuity and intraocular pressure (IOP) of 20/400 and 55 mm Hg, respectively. The refractive error was plano in the right and À3.00 in the left eyes. Anterior chamber of the left eye was significantly shallower and gonioscopy revealed Shaffer grade 4 (OD) and 0 (OS). Fundoscopy showed optic nerve head swelling, soft exudates, generalized narrowing of arteries, and venous engorgement (Figure 1). On the basis of these findings, we checked BP and found it to be 250/160 mm Hg. There were no signs or symptoms of hypertensive encephalopathy and the brain MRI was normal. The patient was admitted for intravenous anti-hypertensive medications. Because of the high BP, mannitol could not be administered and the IOP was lowered to 28 mm Hg using intravenous lidocaine (0.8 mg/kg) and ocular massage. 3 Although fundoscopy showed no choroidal detachment, ocular sonography revealed choroidal thickening and choroidal effusion (Figure 2). Peripheral iridoplasty was carried out and systemic and topical steroid, topical anti-glaucoma, and cycloplegic medications were started.

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