Flashes, Floaters and Haloes

Differential diagnosis

  • Flashes
    • Vitreous detachment
    • Retinal detachment
    • Diabetic changes
    • Papilloedema
    • Migraine
    • Brain lesions
  • Floaters
    • Vitreous condensation
    • Posterior vitreous detachment
    • Vitreous haemorrhage – diabetes, BP

 

Retinal detachment risk factors

  • Myopia
  • Previous eye surgery
  • Family history
  • Collagen disease

 

Retinal detachment red flags

  • New onset floaters (<6/52) – urgent ophthalmology
  • New onset flashes (<6/52) – urgent ophthalmology
  • Reduced visual acuity – same day ophthalmology
  • Relative afferent pupillary defect
  • Fundoscopy – reduced red reflex, detached retinal folds, vitreous opacities