To the Editor: In their Rational Clinical Examination article, Dr Hollands and colleagues1 addressed acute onset of floaters and flashes. The evidence-based review and meta-analysis of historical features related to retinal tears suggested that new-onset symptoms, monocularity, and acute subjective visual reduction determine the need for same-day ophthalmologic evaluation. With the additional information presented on the differential diagnosis of non-ocular causes of acute floaters and flashes, a primary care physician can make a rapid and reasonably effective and accurate determination regarding patient triage.
Katzeff BS. Acute-Onset Floaters and Flashes and Risk for Retinal Detachment. JAMA. 2010;303(14):1369–1370. doi:10.1001/jama.2010.391
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