Objective This study aimed to compare the costs and clinical outcomes of treating patients with retinal diseases requiring surgery managed locally in Darwin through a visiting subspecialist ophthalmology service or transferred to interstate tertiary eye centres. Methods A retrospective analysis of a case series of 70 consecutive patients presenting to the Royal Darwin Hospital for vitreo-retinal surgery during the calendar years 2018 and 2019 was performed. Results Twenty-two of the 29 patients in the transfer group had a retinal detachment and five vitreous haemorrhage. The 41 patients managed in Darwin had a range of diagnoses. Surgical success, complications and costs were similar. Conclusion There were excellent clinical outcomes and a minimal insignificant difference in costs.