Retina · Foundation level · 2 questions
New floaters and flashes
Teaching case · Awaiting clinical review. For professional education; apply clinical judgement and local referral pathways.
Presentation
A 62-year-old with high myopia reports a sudden shower of floaters and flashes in the right eye. Over several hours, a dark curtain has spread across part of the visual field. The eye is not painful. A retinal examination has not yet been performed.
0 of 2 questions completed
Question 1 of 2
Answer: Retinal tear with possible retinal detachment
The sudden floaters, flashes and spreading field shadow raise concern for a retinal tear or detachment. This is a suspected diagnosis requiring examination, not a diagnosis established by symptoms alone.
Why not the other options?
The other options do not account for this sudden combination of symptoms. Do not assume uncomplicated posterior vitreous detachment without assessing the retina.
Question 2 of 2
Answer: Arrange immediate ophthalmic or emergency assessment with a dilated retinal examination
Arrange immediate assessment through the local emergency eye pathway. Retinal detachment is an emergency, and a dilated examination is needed to assess the retina.
Why not the other options?
Waiting, routine follow-up and changing glasses would delay evaluation of a potentially sight-threatening problem.
Retinal detachment: clinical example
Fundus photograph of a horseshoe tear associated with retinal detachment.
Photo: Amaris5 · Original source · CC BY-SA 4.0. Image unchanged.
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Learning points
- A spreading curtain or shadow with new flashes and floaters requires immediate assessment.
- The absence of pain does not remove the urgency.
- Symptoms alone do not establish whether a retinal tear or detachment is present.