Signs of An Eye Emergency

Working in a Level 1 Trauma Center has certainly "opened my eyes" to ocular emergencies.  Very often, patients experiencing an ocular emergency aren't aware of the emergency and neglect time sensitive care which can often result in permanent vision loss.  Symptoms can often be vague and vary in severity leaving a patient confused as to when they need to be seen.  Making the right choice on when to be seen can often be confusing and scary.  However, there are some very important eye signs that should to be evaluated quickly by an eye care professional.

Blurry vision is often the main reason a patient visits their optometrist or ophthalmologist.  Blurry vision can occur out in the distance, at a computer screen or cell phone or during up close reading.  Wherever the blurriness occurs, it needs to be evaluated.  As a doctor, it is always more suspicious when vision changes suddenly, so the patients who say, "all of a sudden I can't see from my left eye," are always a concern.

Eye pain is also most likely not a good sign.  Eye pain usually means something is wrong and can be caused by a range of conditions ranging from pink eye to more severe issues like uveitis or glaucoma.  In either case, your optometrist can prescribe the right treatment to fix the problem.  Very often, in the case of uveitis, eye inflammation can be a sign of other systemic problems like rheumatoid arthritis or other auto immune disorders.  

Flashing lights or black spots can often mean there is a retinal problem.  Very often floaters are caused by the vitreous (the gel behind the eye) forming clumps or strands.  Although these symptoms are usually harmless, sudden onset of floaters or flashing lights could indicate a serious retinal problem such as a retinal detachment or retinal tear.  Depending on the location of the retinal tear or detachment, vision loss can be permanent if not diagnosed and treated expeditiously.  Prompt diagnosis and treatment is essential to preserve vision.

Halos or glare around lights is often a vague symptom but should be assessed by an eye care professional.  Cataracts are typically the culprit with a sudden, painless type of vision loss.  A normal aging change of the lens, cataracts are typically managed at first with eyeglasses and small prescription changes.  But, as the cataract progresses, that no longer works and surgical intervention is needed.  Cataract surgery very often provides improved vision and better quality of life.  

Halos around lights and eye pain can be a very serious, sight threatening symptom.  Pain in the eye with halos can often indicate a serious form of glaucoma called angle closure glaucoma.  This sight threatening eye problem typically means the eye pressure is very elevated because the drainage system of the eye (the "angle") is too narrow or blocked off completely.  This causes a back up of fluid and elevated eye pressure causing a typically deep and throbbing pain with sensitivity to light.  This is a medical emergency and must be treated quickly and aggressively.  A laser procedure is often used to open up the drainage system of the eye so pressure returns to normal.  

Double vision (diplopia) can often be from something as benign as a need for a prescription change in eye glasses or cataracts.  However, double vision should not be taken lightly.  Diplopia can often be caused by an underlying neurological problem such as stroke which interrupts the blood flow to the muscles which make the eye move.  This in turn causes the patient to see double.  These more serious symptoms are often caused by vascular problems such as diabetes or high blood pressure.  All types of double vision should be thoroughly investigated by an eye care professional.

Ocular Traumas can range from not serious to vision and life threatening.  Some early signs of vision problems after trauma include pain and sensitivity to light, double vision, excessive eye redness and light sensitivity, pain in or around the eye, bruising around the eye after a fall or the presence of flashing lights.  Something being splashed in the eye, especially chemicals like cleaning liquids and bleaches should be evaluated and irrigated immediately as well.

A sudden decrease in vision with and without trauma can often be a serious problem.  Often patients tell me, "I didn't realize I couldn't see out of one eye since the other eye picked up the slack."  This is true.  Many people don't realize how poor their vision is until we test their eyes separately.  I tell my patients to cover one eye at a time and look out their windows once a week.  This is a quick and easy way to tell if one of your eyes has lost vision.  Any vision changes should be reported to your eye doctor in a timely fashion.  

Any trauma involving blunt force to the eye needs to be headed to the emergency room.  Trauma to the head can also affect the eye.  Concussions, broken bones around the eye or penetrating injuries in the eye can often involve surgical management.  

The elderly population is particularly vulnerable to falls.  A proper eye examination through a dilated pupil is an important investigative tool to any patient with head trauma.  Safety precautions should always be discussed with patients including proper lighting and assistance with ambulation.  

Animals, as much as we love them, can often bite, scratch or injure the eyes of children and .  Dog and cat bites and scratches to the eye should not be taken lightly,  Dog and cat eye injuries often need more than eye examinations.  Tetanus shots as well as other precautions must be taken to make sure other systemic problems as well as eye problems do not occur.  Bites to the eyelids or tears in the eyelid from animal bites often are referred to plastic surgeons as well as eye doctors for repair.  The team approach very often works in many cases of dog/ cat bites involving the eyes or eyelids.

Whatever your eye concern may be,  it is ALWAYS beneficial to get it checked.  The adage, "better to be safe than sorry" certainly applies here.  Very often, as in many medical conditions, catching the problem early often gives the best prognosis and visual outcome.  Patients with ocular risk factors should be seen regularly as many eye problems can be symptom free.