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    The symptoms of floaters and flashing lights are some of the commonest met in optometric practice. Flashes & Floaters looks at the best way to differentiate those that are caused by innocuous or less worrying conditions, such as ageing and migraine, and those that may be a result of vitreous and retinal changes that, in a few cases, may be indications of more serious and possibly sight-threatening disease.

    Using live footage and animation, the processes of vitreous degeneration, vitreous detachment and retinal detachment are explained. The programme also provides optometrists with guidance on the best way to assess the patient, through careful questioning and a sensible sequence of clinical techniques. Management is discussed against the background of various risk factors and clinical pre-disposing signs to help optometrists decide the nature of the cause and the appropriate management, and to make the right decisions on referral.

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      Learning objectives

      • 1.1.1 The ability to undertake a history and symptoms relevant to a patient presenting with flashing lights and floaters, in order to differentiate any risk factors for retinal disease from other potential causes of the symptoms (such as migraine).
      • 1.1.2 The ability to probe further on reported symptoms of flashes and floaters, to decide upon the potential severity of any underlying condition and therefore the urgency of any management plan.
      • 2.5.3 To understand the appropriate referral of a patient suspected of a recent retinal tear or detachment, of a patient with existing or long term peripheral retinal changes and those of a related presentation but not worthy of immediate referral.
      • 2.8.2 Understand what to record when assessing the retina, when dilating and when referring a suspect detachment.
      • 3.1.2 To understand how to assess Schafer's sign.
      • 3.1.3 To understand how best to view the peripheral retina and understand the relative merits of slit lamp BIO and head set BIO with or without indentation.
      • 6.1.1 To understand the risk factors for retinal detachment, PVD and related conditions including migraine.
      • 6.1.12 To understand the systematic evaluation and assessment of a patient presenting with symptoms of flashing lights and floaters.
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        Unit 2 - Anatomy and epidemiology (~10 mins)

        Essential reading
        Kanski JJ, Clinical Ophthalmology 8th Edition, Butterworth Heinemann
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          Unit 3 - Pre-dilation checks, landmarks and signs (~7 mins)

          Essential reading
          Elliott DB, Clinical procedures in primary eyecare, Butterworth Heinemann

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            Unit 4 - Slit lamp and headset BIO examinations (~10 mins)

            Essential reading
            Elliott DB, Clinical procedures in primary eyecare, Butterworth Heinemann
            Doshi S, Harvey W, Investigative techniques and ocular examination. Optician Publication
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              More information

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