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Age related retinoschisis is a degenerative process occurring in the retina, beginning at the inner front part of the eye nearest the iris. This area slowly enlarges becoming filled with a viscous (thick) substance, filling up like a balloon.

This process advances until the involved retina is completely separated into two degenerated layers, severing the neuronal elements and resulting in complete and permanent loss of all visual function in the involved area (i.e. a blind spot).


Degenerative retinoschisis has a prevalence of 3.7% among patients over age 10, and of 7% among those over 40 years of age. Two forms have been described. One form designated flat (or typical) was thought to be a milder form, versus the other form designated bullous (or reticular, balloon-like), thought to be more severe. It is, however, impossible to differentiate these types of lesions into these categories reliably.

Clinically, degenerative retinoschisis usually presents as a peripheral, smoothly elevated lesion, with a uniformly convex posterior border. It appears as a “water blister” on the retina. The surface of the lesion may show whitened blood vessels, or areas of small whitish flecks called Gunn’s dots. Retinal breaks, as seen in the above photograph, may eventually appear in the outer layer in around 15% of involved patients. Breaks in the outer layer may be of any size, but frequently are huge, and are usually seen to have a prominent whitish rolled border.

It has been long known that these retinal breaks occur in as many as 11% of affected eyes and may be associated with retinal detachment. It has been reported that a schisis-detachment occurs in around 8% of patients with retinoschisis, as opposed to the frequency of retinal detachment in the natural population of 0.05% (or 1 in 2000) patients.

In almost all cases of degenerative retinoschisis (at least 99%), the disease produces no symptoms. Therefore, most existing cases are never discovered. Its presence usually comes to light only when the patient consults their optometrist because of other symptoms, such as those related to a posterior vitreous detachment (PVD). Actual progression of the retinoschisis to involve the macula is exceedingly rare.

Patients with retinoschisis should be followed every 6 to 12 months if no symptoms are reported. However, they should be examined promptly if any change is noted. Patients with retinoschisis should be educated about the signs and symptoms of retinal detachment. Patients need to understand that delaying the reporting of the sudden appearance of flashes of light, floaters, sparkles of light, or shadows, can seriously increase the risk of permanent vision decrease or loss.

Treatment of retinoschisis should only be considered in cases of symptomatic, progressive retinal detachment. It has never been shown that prophylactic treatment statistically preserves vision or prevents complications in cases of degenerative retinoschisis.

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McMann Eye Institute of Honolulu, Hawaii

McMann Eye Institute of Honolulu, Hawaii    McMann Eye Institute of Honolulu, Hawaii  
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The McMann Eye Institute understands how important your vision is to your life. Whether restoring, preserving, or improving sight, our eye doctors are dedicated to optimizing your vision so you can live your best. With doctors that specialize in LASIK, cataracts, glaucoma, diabetic eye care, and cornea surgical treatments, we offer our patients an extensive range of eye care services on the island of O’ahu, Honolulu, Hawaii.

In addition to performing these life changing procedures, we can also help you with simple vision problems and provide preventative vision care for you and your family. Trusted by both patients and doctors, our excellent reputation speaks for itself as we strive to provide the highest quality care in a professional and compassionate environment.

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McMann Eye Institute The Queen’s Medical Center
West O’ahu
91-2139 Ft. Weaver Rd. Suite 202
Ewa Beach, HI 96706
Phone: (808) 677-2733

McMann Eye Institute proudly serves Ewa Beach, HI and the Oahu areas of Honolulu, Waipahu, Aiea, Wahiawa, Kaneohe, Maunawili, Kahaluu, Kapolei, Iroquois Point and the remaining Hawaiian Islands and the Pacific Rim.

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