Objective:

To quantify the absolute and relative risks of retinal detachment (RD) in patients presenting with floaters and flashes in primary care.

Key Findings:

• RD occurred in 6.1% of patients with floaters alone, 4.7% with flashes alone, and 8.4% with both symptoms.
• Patients with acute symptoms (≤14 days) or many floaters had significantly higher relative risks of RD.
• Incidence rates were 5.5 per 1,000 patient-years for floaters and 2.7 for flashes.
• Overall, RD developed in 6.5% of episodes presenting with these symptoms.

Interpretation:

Floaters, especially when acute or numerous, may be a stronger warning sign for RD than previously emphasized flashes, suggesting a need for revised clinical guidelines.

Limitations:

• The study is retrospective and may not capture all cases of RD.
• Findings are based on a specific population and may not be generalizable.

Conclusion:

The study advocates for greater attention to floaters in risk assessment for RD in primary care, recommending urgent referral for patients with recent-onset or multiple floaters.