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April 14, 2010

Acute-Onset Floaters and Flashes and Risk for Retinal Detachment—Reply

JAMA. 2010;303(14):1369-1370. doi:10.1001/jama.2010.393

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.