In primary care, for a patient presenting with new-onset floaters and flashes, the initial investigations should focus on a thorough ocular examination including visual acuity assessment and fundus examination to detect any retinal abnormalities such as retinal tears or detachment. This can be done using slit-lamp biomicroscopic fundus examination if available. If retinal abnormalities are suspected or the examination is inconclusive, urgent referral to hospital eye services is warranted for further assessment and management. Additionally, assessing intraocular pressure and excluding other causes such as glaucoma may be considered, but the priority is to identify any sight-threatening retinal pathology promptly.
What initial investigations should be performed in primary care for a patient presenting with new-onset floaters and flashes?
Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.
Posted: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX