Two patients receiving hemodialysis for chronic renal failure developed bilateral bullous retinal detachment associated with multiple underlying serous detachments of the pigment epithelium. Many of the detachments of the pigment epithelium were surrounded by subretinal whitish exudate that was probably fibrinous in type. There was fluorescein angiographic evidence of dehiscence of the pigment epithelium at the margin of some of the pigment epithelial detachments. Failure to recognize the nature of the retinal detachment in one patient resulted in an unsuccessful scleral buckling procedure.