White Without Pressure

White Without Pressure
SYMPTOMS Asymptomatic
SIGNS Typically bilateral
Milky white-gray bands of retinal translucence (especially when compared to the surrounding retina) that is usually well demarcated by a posterior border that is dark red in color
WORK-UP Full eye exam with dilated retinal exam, Scleral depression, Peripheral 90D, Gonioscopy 3-mirror (using retina mirrors)
TREATMENT No treatment is needed and retina needs to be monitored
FOLLOW-UP See patient back in 12 months
ETIOLOGY Etiology is unclear but thought to be an optical phenomenon or reflex produced by vitreoretinal traction or adhesion
DIFFERENTIAL DX Retinal detachment, White with pressure, Snail track degeneration, Peripheral cystoid degeneration, Commotio retinae
NOTES Can be found in about 30% of patients
More commonly found in patients that are myopic
Can change shape and look different from year to year
White with pressure is a retinal finding only produced when doing scleral depression
White Without Pressure: Optos photo demonstrating white without pressure in the superior temporal, temporal, and inferior temporal aspect of the peripheral retina https://recognizingpathology.optos.com/white-without-pressure/