Tractional RDs are recognized by the presence of pre- or subretinal membranes (bands/strands)² and by the concave profile of the detached retina. The traction exerted by the membranes is stationary; the height and shape of the RD do not change with the position/movement of the eye/head.

Such membrane-related traction is also the dominant element in a combined RD; the presence of the retinal break does not determine the appearance or behavior of the RD, but it does have management implications (see below).

Because the traction is not dynamic, bedrest and bilateral patching do not change the height or size of the detachment. For the same reason, the progression of the RD is slow, even if a break is present.

Surgery is thus even less urgent than in eyes with a rhegmatogenous RD; conversely, it is even more crucial in these eyes than in those with a rhegmatogenous RD to completely eliminate the preretinal traction. Subretinal membranes do not require complete removal, breaking them into two may be sufficient, and those that may stretch enough to allow retinal reattachment in spite of their presence may be left behind (see Sect. 32.​4).

If the membranes are vascularized, 2–3 days preoperatively an intravitreal bevacizumab injection should be given (see Sect. 52.​1).