Ten cases of retinal pigment epithelial tears were observed in eight patients with serous pigment epithelial detachments associated with age-related macular degeneration. Eight of the ten tears were spontaneous and all occurred at the detachment margin. The resulting area of exposed choroid was sometimes initially mistaken for pigment epithelial atrophy. In two cases it was misdiagnosed as choroidal neovascularization and treated with laser photocoagulation. All but two patients suffered severe visual loss.