Urgent Flashes and Floaters

This column will review the risks of waiting eight to 12 hours to make this diagnosis and determine whether it is reasonable for the patient to simply prepare for possible surgery in the morning.

While the data suggests we can be flexible concerning the timing of surgical repair for macula-on detachments, those involving giant retinal tears that are superiorly located and encroaching on the macula should be treated as an ocular emergency. When barriers exist to timely surgery, however, limited activity and bed rest should be considered. Some advocate occluding both eyes to limit saccadic eye movements, which can increase fluid dynamics and migration into the subretinal space.

Dr. Dexter's Take
Optometrists often joke that we always receive calls on Friday afternoons from patients who have symptoms of flashes and floaters. We squeeze them into the schedule at the end of the day and we always seem to find a retinal tear or retinal detachment just before we'd like to leave the office at 5pm. Any other day or time of the week, flashes and floaters symptoms always end up being uncomplicated posterior vitreous detachments. 

This article reviews the risks of a posterior vitreous detachment resulting in an eventual retinal detachment, predictive factors or clinical findings that should raise concern for a retinal break, and the urgency for surgical repair of a retinal tear or detachment. 

Read the full article from Review of Optometry

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