Ocular Emergencies Summit
Join Woo U for our Ocular Emergencies Summit where the various types of ocular emergencies will be detailed and discussed.
Our eyes are susceptible to injuries, infections, and acute conditions that may require immediate medical attention. It is imperative that eye care professionals be aware of these conditions and be able to identify them in a clinical setting. Ocular emergencies must be dealt with in a timely manner in order to ensure the best patient outcomes. The following article quickly showcases common ocular emergencies and how to differentiate them
What is an Ocular Emergency?
An ocular emergency is any sudden eye condition that requires immediate medical intervention to prevent severe damage to vision or the eye itself. These emergencies can result from trauma, infections, acute diseases, or systemic health conditions affecting the eyes.
Common Ocular Emergencies
Chemical Burns
Chemical Burns
Causes:
Exposure to acids (e.g., battery acid, vinegar) or alkalis (e.g., ammonia, bleach, cement)
Industrial accidents or household cleaning products
Accidental splashes while cooking or working with chemicals
Symptoms
Severe pain and burning sensation
Blurred vision
Redness and swelling
Excessive tearing
Immediate Action:
Rinse the eye immediately with copious amounts of clean water or saline solution for at least 15 minutes.
Avoid rubbing the eye.
Seek immediate medical attention
Corneal Abrasion
Corneal Abrasion
Causes:
Foreign objects (e.g., dust, sand, metal shavings)
Contact lens misuse
Scratches from fingernails or tree branches
Symptoms
Gritty sensation in the eye
Redness and tearing
Light sensitivity
Blurred vision
Immediate Action:
Rinse the eye with saline solution or clean water.
Avoid rubbing or applying pressure.
Most commonly treated with topical antibiotics
Retinal Detachment
Causes:
Severe myopia (nearsightedness)
Trauma to the eye or head
Age-related changes in the vitreous humor
Diabetic retinopathy
Symptoms
Sudden flashes of light
Increase in floaters (tiny spots or cobweb-like shapes in vision)
A shadow or curtain effect across part of the visual field
Immediate Action:
Lie down with your head positioned so that gravity helps keep the retina in place.
Dilated exam with or without scleral depression
Vitrectomy – most common procedure.
Involves removing the vitreous and replacing it with a gas bubble or silicone oil.
Pneumatic retinoplexy
Involves a gas bubble
Laser photocoagulation
A laser is used to seal holes or tears in the retina
Cryoplexy
A freezing probe is used to create scar tissue that seals the tear
Acute Angle-Closure Glaucoma
Photo: University of Iowa - Department of Ophthalmology and Visual Sciences
Causes:
Sudden blockage of the drainage channels in the eye, leading to increased intraocular pressure
Family history of glaucoma
Certain medications (e.g., antihistamines, antidepressants)
Symptoms
Sudden, severe eye pain
Blurred vision
Halos around lights
Nausea and vomiting
Immediate Action:
This condition requires urgent medical attention, as it can lead to permanent blindness within hours.
Medications such as eye drops to lower intraocular pressure and surgical interventions may be necessary.
LPI (Laser Peripheral Iridotomy)
A laser is used to create a small hole in the iris to allow for aqueous outflow
Cranial Nerve Palsies
Causes:
Stroke or transient ischemic attack (TIA)
Head trauma
Tumors affecting the cranial nerves
Infections such as meningitis
Diabetes-related neuropathy
Symptoms
Double vision (diplopia)
Drooping eyelid (ptosis)
Misalignment of the eyes (strabismus)
Difficulty moving the eye in certain directions
Immediate Action:
Seek medical evaluation immediately, as some cranial nerve palsies indicate serious underlying conditions like stroke or brain tumors.
Imaging studies such as MRI or CT scans may be required.
Treatment depends on the underlying cause and may involve managing diabetes, physical therapy, or surgical intervention.
Double vision can be treated with prism in glasses if longstanding
Orbital Cellulitis
Photo: Review of Optometry
Causes:
Bacterial infection from sinusitis
Trauma or surgery near the eye
Spread of infection from other parts of the body
Symptoms
Pain and swelling around the eye
Bulging of the eye (proptosis)
Restricted eye movement
Fever and general malaise
Immediate Action:
Prompt antibiotic treatment is essential to prevent complications like vision loss or brain infections.
Hospitalization may be required for intravenous antibiotics
Central Retinal Artery Occlusion (CRAO)
Photo: Retina Image Bank - The American Society of Retina Specialists
Causes:
Blockage of the central retinal artery due to embolism or thrombosis
Cardiovascular diseases, hypertension, diabetes
Blood clotting disorders
Symptoms
Sudden, painless vision loss in one eye
A cherry-red spot on the retina (visible upon examination)
Immediate Action:
Immediate medical attention is crucial to restore blood flow and minimize permanent vision loss.
Treatments may include ocular massage, medications, or hyperbaric oxygen therapy
Hyphema
Causes:
Blunt trauma to the eye (e.g., sports injuries, falls, physical altercations)
Blood clotting disorders
Symptoms
Blood accumulation in the anterior chamber of the eye
Blurred vision
Sensitivity to light
Immediate Action:
Elevate the head to prevent further bleeding.
Avoid strenuous activities.
Eye shield to protect eye
Monitor for signs of glaucoma/ increased eye pressure
Cycloplegic drops can be used to reduce pain/ light sensitivity
Foreign Body in the Eye
Causes:
Metal, glass, or organic debris entering the eye
Workplace accidents, especially in construction or manufacturing settings
Symptoms
Sharp pain and irritation
Excessive tearing and blinking
Redness and difficulty opening the eye
Foreign body sensation
Immediate Action:
Do not rub the eye.
Flush with clean water or saline.
In office removal using cotton tip applicator or alger brush
Antibiotics following removal if corneal epithelium is disrupted
Preventing Ocular Emergencies
While some ocular emergencies are unavoidable, many can be prevented by taking simple precautions. It is important to properly educate patients on the following to best prevent ocular emergengies.
Wear protective eyewear when working with chemicals, using power tools, or playing sports.
Follow proper contact lens hygiene to reduce the risk of infections and corneal damage.
Control underlying health conditions such as diabetes and hypertension to prevent vascular-related eye emergencies.
Seek medical attention promptly for any unusual eye symptoms to prevent complications.
Ocular emergencies can be frightening and potentially devastating, but quick and appropriate action can make a significant difference in preserving vision. Understanding the symptoms and knowing how to manage them can help mitigate the damage and improve the chances of a full recovery. Eye care professionals should be able to identify ocular emergencies and take the appropriate steps to coordinate care for patients.
By popular request, Woo U has organized a weekend long event highlighting several courses on the topic of ocular emergencies. We will be covering different types of emergencies ranging from cornea, retina, neurological, trauma, and much more. Earn up to 8 hours of COPE approved CE credit and learn from expert faculty.
