Common Ophthalmic Emergencies

G. D. Khare; R. C. Andrew Symons; D. V. Do

Disclosures

Int J Clin Pract. 2008;62(11):1776-1784. 

In This Article

History

Although it may be difficult to determine which ophthalmic presentations are vision threatening and require emergent care, a careful patient history may provide several important symptoms including reduced visual acuity, visual field changes, floaters, photopsia, head, orbital or ocular pain, changed appearance of the ocular adnexae, ptosis, diplopia and alterations in the pupil size. If the symptoms are severe or rapidly progressive, urgent referral to an ophthalmologist is appropriate.

Past ophthalmic and general medical history gives the background for the current presentation. It is important to determine whether the current presentation could be a recurrence or a complication of a previous ophthalmic condition. Always ask about any recent ophthalmic or orbital surgery. Possible complications of ophthalmic surgery include endophthalmitis and other infections; corneal epithelial defects; raised or lowered intraocular pressure (IOP); hyphema; vitreous haemorrhage; and, retinal detachment. Orbital surgery may be complicated by infection, haemorrhage, and damage to the extraocular muscles or optic nerve. Nasal and sinus surgery may also have orbital complications.

It is also important to be aware of systemic diseases which may have ophthalmic manifestations. Common systemic conditions that affect the eyes include diabetes and thyroid disease, hypertension, autoimmune and inflammatory diseases, infectious disease and malignant disease.

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