The presence of a retinal detachment may be determined using ultrasonography if an adequate view of the posterior segment is not possible. Vitrectomy is performed urgently when a retinal detachment or break is identified. Provided the retina is attached, observation is on an outpatient basis. If the view to the posterior pole is blocked, limitation of activities and elevation of the head of the bed while sleeping may allow the blood to settle inferiorly and permit visualization of the superior retina where retinal breaks most commonly occur. Retinal breaks are sealed with cryotherapy or laser photocoagulation. If a retinal detachment has been ruled out, patients may return to normal activities. Once the retina can be visualized, treatment is aimed at the underlying etiology as soon as possible. If neovascularization from proliferative retinopathy is the cause, laser panretinal photocoagulation is performed, if possible through the residual hemorrhage, to cause regression of neovascularization. A krypton laser may aid photocoagulation as it passes through hemorrhage better than argon lasers. An indirect laser system may also allow energy delivery to the retina around a vitreous hemorrhage. Alternatively, in the interim, intravitreal anti-VEGF agents may induce regression of the neovascularization until laser photocoagulation is possible. Vitrectomy is also indicated for nonclearing vitreous hemorrhage, neovascularization of the iris and/or angle, or ghost cell glaucoma. Timing of vitrectomy depends on the underlying etiology.