Reassessment of Scleral Depression in the Clinical Setting

The standard of care for diagnosis of peripheral vitreoretinal pathology (such as retinal breaks, tears, or holes) is to perform indirect ophthalmoscopy with scleral depression; however, this is only supported by the “lowest strength of evidence.” 1 American Academy of Ophthalmology Retina Panel Preferred Practice Pattern Guidelines. Posterior vitreous detachment, retinal breaks, and lattice degeneration. American Academy of Ophthalmology, San Francisco2013 Google Scholar For the patient, scleral depression causes discomfort owing to mechanical pressure on the globe. The few published reports in the literature on the topic of scleral depression describe the technique of scleral depression, but do not provide any comparison with examination without scleral depression. 2 Townsend W.D. Scleral depression. Optom Clin. 1992; 2: 127-144 PubMed Google Scholar , 3 Trantas A. Moyens d’explorer par l’ophthalmoscope et par translucidite la partie anterieure du fond oculaire, le cercle ciliare y compris. Arch Ophthalmol (Paris). 1900; 20: 3140-3226 Google Scholar , 4 Krausher M.F. Learning scleral depression with binocular indirect ophthalmoscopy. Am J Ophthalmol. 1979; 87: 97-99 Abstract Full Text PDF PubMed Scopus (3) Google Scholar , 5 Schepens C.L. Techniques of examination of the fundus periphery. in: Symposium on retina and retinal surgery. Transactions of the New Orleans Academy of Ophthalmology. Mosby, St. Louis1969: 39-51 Google Scholar