Eye Emergencies and Non Emergencies

Eye Emergencies - what to do

If you feel your eyes suddenly become irritated, try not to panic, and avoid rubbing your eye. Rubbing the eye or eyes can make the symptoms worse.
Irritated eyes may not necessarily be an emergency, - if you experience any eye pain whilst wearing contact lenses remove the lens or lenses - it could be that something is trapped under your lens, and simply removing the lens will ease the irritability. If after removing your lens(es) your eye continues to be irritable, painful, and/or red you should seek medical attention urgently.

The causes of red irritable eyes can be classified into two groups

1. No pain and normal vision
2. Pain with or without blurred vision

As a general rule eye irritability with no pain and normal vision is not an emergency and eye irritability with pain, whether the vision is blurred or not is likely to be an emergency, as it could be an indication of a life-threatening condition. A recent study involving over 1900 patients showed that truly urgent cases included symptoms of eye pain, ocular trauma, tearing, blurred vision, photophobia, floats and visual field defect.

Non-eye Emergencies

Contact lens wearers can experience all of the same eye conditions and causes of pain as a non-contact lens wearer such as allergies, irritants in the eye, etc, however, for contact lens wearers there are an added few issues to be aware of such as:

• Lenses have been irritated by an irritant such as animal hair, dust, shampoo, makeup
• Not using clean, fresh solution to rinse or store your lenses
• A torn contact lens
• A lens stuck under the eyelid 
• Not neutralising a hydrogen peroxide solution sufficiently
• Allergic reaction to an ingredient within the contact lens solution
• General allergies such as hay fever
• Medication
• Scratching the eye with a fingernail

If you feel your irritated and painful eye has been caused by one of the above issues then, wash and dry your hands, remove your lens, and if possible rinse your eye with saline or multipurpose solution. If the irritability or pain does not reduce in an hour or so then seek advice from your Optometrist or go to your Emergency Department at the local hospital.

Eye Emergencies

• A sudden blind and painful eye, causing sickness and feelings of being unwell
• Chemical splash
• Foreign object in the eye
• Trauma, i.e. being hit in the eye causing lacerations to the eye or eyelids
• Sudden and painful, red, swollen eye following eye surgery
• Rapidly deteriorating vision
• Shadows or 'curtaining' in the field of vision which is painless but may be associated with flashing lights or an increase in seeing black specks or blobs (floaters)
• A red and painful eye associated with wearing contact lens 
• Loss of vision
• Eye Infection
• Any pain that does not reduce after removing your lenses and raising the eye, whether there is blurred vision or not

This is a comprehensive list of situations and symptoms that would indicate you need to attend an emergency department at your local hospital. It is impossible to cover every symptom or experience that may be classified as an emergency, if in doubt, and if possible, remove your contact lenses immediately and seek medical help.

According to Oxfordshire Local Optometric Committee eye emergencies can be broken down into Red Flags, General Health (Yellow Flags), and Self Care (Green Flags), and Minor Eye Conditions (Blue Flags)

Red Flags

• Serious injury
• Severe eye pain
• Sudden and sustained loss of vision 
• Sudden onset of double vision 
• Eye surgery in the last 30 days 
• History of uveitis/iritis and possible recurrence 

If you experience any of these symptoms go to an emergency department immediately

Yellow Flags

• Severe headaches for less than one month
• Swollen eyelids and fever

If you experience either of these conditions you should book an urgent appointment with your GP

Green Flags

• Eye discomfort but not severe pain 
• Sticky/itchy eye for less than one week 
• Vision normal except after watering
• No new light sensitivity
• No injury or foreign body

If you experience any of these symptoms, over-the-counter medication is available from the pharmacy. Drops are available for bacterial conjunctivitis, eye allergy, and dryness.

If symptoms markedly worsen or persist for longer than one week see your family doctor or emergency department

Blue Flags

• New flashes and floaters (less than 6 weeks)
• Persistent red, sore, gritty, sticky, itchy, eyes or eyelids (for more than 1 week) 
• Non-penetrating foreign bodies
• In-growing eyelashes 
• Recent sudden change of vision
• Eyelid lumps and bumps

If you experience any of these symptoms then see your local optometry practice that provides minor and urgent eye care services- this may not be your regular opticians' practice, but you can find your nearest practice at Primary Eyecare 

It can sometimes be difficult to determine whether a painful, red, and irritated eye is something that requires immediate medical attention or not. If in doubt always remove your contact lenses and seek medical attention.