Newcastle upon Tyne SUMMARY Purpose. The aim of the study was to determine whether patients presenting with an isolated posterior vitreous detachment require follow-up to identify retinal breaks not apparent at presentation and whether some histories are more predictive of asso ciated serious posterior segment pathology.Methods. The notes of 295 patients presenting to eye casualty with flashes andlor floaters were reviewed.Results. One hundred and eighty-nine patients (64%) had isolated posterior vitreous detachments, 49 (16.6%) had retinal detachments and 31 (10.5%) had flat retinal tears. Three new breaks (3.3% of all tears found, 1.9% of review appointments) were identified only at follow-up. Although a subjective reduction in vision and a history of less than 6 weeks' duration were strongly predictive of retinal breaks, the large group of patients presenting with floaters alone (124/295, 42 %) still harboured a significant proportion (26.7%) of the retinal breaks. Conclusions. A follow-up visit for patients with anisolated posterior vitreous detachment can be justified to detect the small percentage of asymptomatic retinal breaks. Although a subjective reduction of vision is the symptom most predictive of serious posterior segment pathology, it would be unsafe to identify particular subgroups of patients alone for careful examination.Patients complaining of flashes and floaters make up a significant proportion of the cases presenting to eye casualty departments. Of these, between 10% and 30% 1-3 will have retinal breaks requiring immediate treatment and approximately half will have an isolated posterior vitreous detachment. ! , 4 The latter group are usually followed up in outpatients approxi mately 6 weeks after the onset of symptoms, to allow the identification of retinal breaks which may have developed after the first visit.Our aims were to determine whether significant pathology associated with posterior vitreous detach ment was being detected at the follow-up visit and to identify characteristics of the history which were more strongly indicative of the presence of retinal breaks or detachments. PATIENTS AND METHODSWe retrospectively studied 295 consecutive patients who presented to eye casualty in 1993 and 1994 with symptoms of floaters and/or flashes due to posterior vitreous detachment. Patients who were referred directly to outpatients, or who had a history of trauma or concurrent posterior segment disease such as diabetic retinopathy and vascular occlusions, were excluded. All had been examined at the first visit by the senior house officer in casualty and a diagnosis of separation of the posterior vitreous face from the retina was made using slit lamp biomicroscopy with the 90 dioptre lens or Goldmann 3-mirror contact lens. Indirect ophthalmoscopy with scleral indenta tion was also performed to identify any peripheral retinal pathology and patients were then treated immediately as necessary or given a retinal detach ment warning and followed up in clinic. Patients' symptoms, pathology, timing of f...

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A review of 783 patients with non-penetrating, superficial corneal foreign bodies (FBs), indicated that delay in rehabilitation was related to two factors: (1) the size of the abrasion following removal of the FB, larger abrasions requiring longer duration of antibiotic ointment, and (2) inadequate removal of corneal rust. Allergy to chloramphenicol 1% ointment (5.5 in 1000), commonly used in the management of corneal abrasions, is unpredictable and can also impair rapid rehabilitation.