CET feedback: Retinal detachment interactive

For this exercise, you were asked to consider the following scenario:

A 42-year-old -3.00DS myope attends a community eye care practice at 16.30 having noticed a sudden appearance of a ‘cob web-like’ disturbance in the right eye and awareness of a ‘sparkling’ disturbance down to their right which he says he notices ‘from time to time’ and can still see now. He has driven to your practice, having left work early, as is worried.

The exercise was aimed at encouraging discussion about managing such a walk-in and also to discuss the possible implications of dilating a driver. Most of you recognised that the symptoms as described could represent evidence of a posterior vitreous detachment (PVD). As explained in the source material: ‘When an optometrist is presented with a patient whose symptoms suggest PVD, the approach should be: this patient has a one in 10 chance of having a retinal tear. The symptoms will not tell me if he is among the unlucky 10% – he needs a dilated examination in order to find out.’