Eye Emergency Decisions Start With A Phone Call

By Scott Burge, OD

Maryland Eye Associates

. http://marylandeyeassociates.com

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Eye Emergency Decisions Start With A Phone Call

Most of us have experienced some form of eye pain event or a blurred vision event. When something happens, the question “is this an emergency?” comes to mind. You as the person with the symptom(s) as well as we, the doctors, and our staff often must make a decision over the telephone about the severity of the condition and the immediacy of care and treatment required.
Two questions determine how critical a condition is. “Is there any vision loss?” “Is there any pain?” The question of vision loss includes blurred vision, vision that is changing and worsening, wavy and/or distorted vision, disturbed or double vision, the presence of light flashes and/or something floating in the vision, as well as a section of missing vision that may be either central or peripheral. In other words is your vision perfectly fine, or is something wrong?
The question of pain includes several categories. The eye may hurt so much that it is constantly covered by ones hand. Pain may be described as an intense ache or a sharp stabbing feeling. Associated with pain, there may be extreme light sensitivity, intense headache, and extreme tenderness to touch around the eye, as well as swelling and redness. All of these vision loss and pain symptoms indicate the high probability of a serious medical condition. If the answer is yes to either question, then evaluation should occur the same day of the phone call. For example, a red eye that feels fine and has normal vision is most likely not an emergency and therefore does not require same day evaluation. However, seeing light flashes with something floating in the peripheral vision of one eye is likely the classic symptom of vitreous detachment, which may cause or be associated with retinal detachment. This requires same day evaluation.
Sometimes it is obvious that immediate care is necessary. Other times its not. Also consider the tendency of people to deny the severity and significance of symptoms being experienced. Phone call assessment is a very important part of the health care delivery process. Never hesitate to pick up the phone and ask if evaluation is necessary. When answering your call, the front desk is trained to determine the immediacy of your condition. If the eye hurts and vision is blurry, a variety of conditions requiring same day care are possible. For the post cataract surgery patient, there could be unexpected internal or external infection. For the contact lens wearer there could be the sudden onset of a corneal ulcer caused by sleeping with lenses. For the gardener who gets poked in the eye while pruning bushes, there could be a scratched cornea or foreign body with significant risk of fungus infection from live plant material. Anyone working with chemicals ranging from common household cleaners, glue, and stain removers to industrial agents that splash into the eye needs immediate evaluation for chemical burn.
Often one has symptoms that raise the question of a potential problem, however what is going on is not obvious to the individual experiencing the symptoms. It is not normal to have eye pain, foggy vision and halos around lights, which collectively could indicate narrow angle glaucoma. Many people commonly write off symptoms to “allergies” or “tired eyes”, when in fact a serious sight threatening condition is occurring. The symptom of double vision could simply be caused by astigmatism and the need for a new eyeglass prescription. On the other hand it could be the result of a “mini” stroke or a sign of uncontrolled diabetes. If the onset is sudden, as in “yesterday, I was fine, but today Im not”, that is a red flag indicating the need for same day evaluation.
Prompt evaluation and treatment always assures a better outcome. When a section of vision is missing or very blurry vision, retinal detachment or a branch vein occlusion may have occurred. Treatment delayed for days or weeks will significantly reduce the possibility of saving or restoring vision. Be mindful of your symptoms. Do not deny that something is happening. Make the telephone call to the professionals that are there for you.