Diagnosis is based on ophthalmoscopy with scleral depression and contact lens examination. The fellow eye should also be examined.

Differential diagnosis

Degenerative retinoschisis can easily be confused with retinal detachment (rhegmatogenous and exudative). Differentiation between these two conditions is extremely important since retinal detachment almost always requires treatment, while retinoschisis usually does not (or only occasionally).

The differential diagnosis between retinoschisis and retinal detachment is usually made on the basis of clinical examination. Clinically, retinoschisis is more transparent, less mobile, has less surface wrinkling, and exhibits less underlying retinal pigment epithelial atrophy than full-thickness retinal detachment. Optical coherence tomography can be used as an additional diagnostic method if differential diagnosis cannot be made clinically.

X-linked juvenile retinoschisis and secondary retinoschisis (due to diabetic retinopathy, retinopathy of prematurity) should also be considered.