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August 1972


Arch Ophthalmol. 1972;88(2):228. doi:10.1001/archopht.1972.01000030230020

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To the Editor.  —Dr. Lyall raises an interesting point when he notes that retinal detachments originating from inferior breaks may rise as much as three hours above the level of the break, in contrast to retinal detachments from superior breaks which rarely rise more than 1½ hours above the level of the break. We too recognized the discrepancy and were puzzled by it. After some thought we arrived at what we believe to be a likely explanation. We omitted it from the article because it was theoretical and because the article was already as long as we felt the editorial board would suffer. Dr. Lyall's question provides a welcome wedge to the reopening of the subject.Inferior detachments probably advance superiorly (that is, above the level of the hole of origin) during sleep when the patient is in a horizontal position. The gravitational effect which, during the upright hours, causes

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