JAMA: 2009-11-25, Vol. 302, No. 20, Author in the Room™ Audio Interview

Interview with Hussein Hollands, MD, MSc, author of Acute-Onset Floaters and Flashes: Is This Patient at Risk for Retinal Detachment? Summary Points: 1. The most likely cause of acute onset monocular floaters or flashes is posterior vitreous detachment. If left untreated, vitreous detachment complicated by retinal tear can progress to vision-threatening retinal detachment. 2. A minimum approach to evaluating a patient with suspected posterior vitreous detachment should include a history of change in vision or curtain of darkness, measurement of visual acuity, and assessment of confrontational visual fields. 3. High-risk features for retinal tear in the setting of acute posterior vitreous detachment are subjective or objective visual acuity loss, monocular visual field loss (or curtain of darkness), and vitreous pigment or hemorrhage on slit-lamp examination. Patients with any of these clinical findings should be referred for same day ophthalmology assessment.