A total of 589 patients (369 women and 220 men, 123 of whom were less than 40 years old and 52 of whom were more than 70 years old) with photopsia, vitreous floaters, or both participated in a prospective study designed to identify patients at particularly high risk for retinal tears. The patients were graded on a number of factors before undergoing peripheral retinal examinations. Computer analysis showed that the following factors had the strongest associations (P less than .001) with retinal tears: visual symptoms of diffuse dots (62 of 120 patients, or 51.7%), many vitreous cells (graded 2+ or worse) (61 of 94 patients, or 64.9%), and grossly visible vitreous or preretinal blood (51 of 56 patients, or 91.1%). Of the 176 eyes that had at least one of these three conditions, 93 (52.8%) had retinal tears compared to 16 of the remaining 413 eyes (3.9%). Although other factors correlated with retinal tears to some degree, the associations were not strong enough to help select the high-risk group.