In Reply: In response to Dr Katzeff, we believe that a minimum evaluation for a patient presenting with presumed acute posterior vitreous detachment (PVD) should include focused history, visual acuity measurement, and confrontational visual fields. This evaluation is time-efficient (no more than 10 minutes in total) and should be feasible for busy generalist and emergency department physicians; we consider it essential for appropriate triaging. Slitlamp examination and direct ophthalmoscopy can also be informative, although we recognize not always practical, and depend more on physician expertise and comfort.
Hollands H, Johnson D, Sharma S. Acute-Onset Floaters and Flashes and Risk for Retinal Detachment—Reply. JAMA. 2010;303(14):1369-1370. doi:10.1001/jama.2010.393