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This case study is interesting because it highlights the need to examine the peripheral retina even in seemingly asymptomatic patients as there may often be changes that can lead eventually to serious sight-threatening pathology. There will be many people reading this article who will have seen patients for, say, a routine two-year recall and upon asking them about their visual state will receive a reply that tells them that since the last eye examination they have been seen in the eye clinic and been treated for a tear in the retina or even a retinal detachment. Often this may come as a surprise to the examining clinician and when reviewing their notes of the previous visit they will find the patient was asymptomatic and there was no evidence of any retinal damage. Clearly, where routine ophthalmoscopy through undilated pupils was undertaken, the periphery would not have been viewed and hence any peripheral degenerations would not have been noted, let alone any action taken or advice given to prevent further problems in the future.
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