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Retinal detachment — MCCQE Part 1 MCQ

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ModerateVisual DisturbanceRetinal detachmentMCCQE Part 1

58-year-old myopic man presents with flashes, floaters and a curtain over vision. There is no eye pain and visual field is reduced superiorly. Which of the following is the most appropriate next step?

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Correct answer: D — Arrange same-day ophthalmology assessment

Arrange same-day ophthalmology assessment is best because flashes/floaters with curtain visual loss suggest retinal detachment. Discharge with reassurance and routine follow-up only is suboptimal because it underestimates acute or progressive risk; Treat symptomatically and defer definitive assessment is suboptimal because symptom control alone does not address the likely underlying diagnosis; Arrange non-urgent outpatient imaging in several months is suboptimal because delayed imaging is unsafe when the presentation has red flags; Start long-term corticosteroids without confirming the diagnosis is suboptimal because empiric steroids can obscure infection, malignancy or other diagnoses. Macula-on detachments are particularly time-critical.

Reference: Canadian Ophthalmological Society guidance