What is the recommended management protocol for a patient with a recent onset of floaters and flashes in the vision?

Recommended management protocol for recent onset of floaters and flashes:

• Arrange an urgent referral to an ophthalmologist with retinal surgery expertise on the same day if there are signs of sight-threatening disease such as visual field loss, changes in visual acuity, or fundoscopic signs of retinal detachment or vitreous haemorrhage.
• If there are no visual field loss, no change in visual acuity, and no fundoscopic signs of retinal detachment or vitreous haemorrhage, arrange an urgent referral to a practitioner competent in slit lamp examination and indirect ophthalmoscopy to be seen within 24 hours.
• Provide the patient with information and advice about the early warning signs of retinal tear or detachment and the need for immediate ophthalmology assessment if symptoms worsen.
• Advise the patient to contact the Driver and Vehicle Licensing Authority (DVLA) if they have a visual field defect or have had retinal treatment in both eyes.
• Recommend wearing eye protection during at-risk sports to reduce the risk of eye injury and future retinal detachment.
• Retinal tears or breaks identified are treated by laser therapy or cryotherapy to prevent progression to retinal detachment, which may require surgical intervention such as vitrectomy, scleral buckling, or pneumatic retinopexy depending on the case.

Early referral and timely specialist assessment are critical to prevent progression to sight-threatening retinal detachment and to improve visual outcomes.