When are simple flashes and floaters ocular emergencies?

One hundred and seventy patients presented to the Bristol Eye Hospital casualty department with flashes and/or floaters during a six month prospective study. A sight-threatening condition was found in 41 patients (24.1%), the most important of which was a retinal break (16.5%). Although there were no specific symptoms which could be correlated to an increased incidence of retinal breaks, those patients who complained of isolated uniocular floaters had an insignificant incidence of breakage, when compared to asymptomatic fellow eyes. Thus while the majority of patients with flashes and floaters do merit an urgent ophthalmological opinion, those who complain of a single, isolated floater can safely be reviewed as routine outpatients.