Questionnaire/history: New onset of floaters (eg mobile dots, lines or haze of varying translucency)? New onset of flashes (eg light often seen as recurrent, brief flashes)? Sudden onset of painless and unusually progressive visual field loss (eg dark curtain or shadow)? Reduction in visual acuity, blurred or distorted vision, causing persistent and progressive visual loss? Past medical history? Risk factors? - Retinal detachment? - Short-sightedness? - Eye trauma? - Cataract surgery? - Proliferative diabetic retinopathy? - Inflammatory conditions (eg uveitis, scleritis)? - Congenital eye disease (eg glaucoma, cataract or retinopathy)? Family history (eg retinal detachment)? Current medication? Drug allergies? Examination: Reduced visual acuity using a Snellen chart? (Note: vision may be reduced to finger counting or hand movements if the macula is detached) Peripheral field vision loss by performing confrontational field testing? Relative afferent pupillary defect (pupil dilates or stays the same when light is shown on it) suggesting optic nerve damage? Fundoscopy findings? - Asymmetric red reflex? - Vitreous opacities? - Detached retinal folds? Management: Immediate referral to ophthalmologist with retinal surgery expertise to be seen on the same day, if: - Visual field loss or changes in visual acuity - Fundoscopy signs of retinal detachment or vitreous haemorrhage Urgent referral to a practitioner competent in the use of a slit lamp examination and indirect ophthalmoscopy to be seen within 24 hours, if - No visual loss - No change of visual acuity - No fundoscopy signs of retinal detachment or vitreous haemorrhage Reference(s): NICE CKS: Retinal detachment EyeWiki: Retinal Detachment Information for patient/carer(s): NHS Health A to Z: Floaters and flashes in the eyes Patient UK: Retinal detachment Royal College of Ophthalmologists: Understanding retinal detachment