Eye Emergencies

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Eye Emergencies 1
Eye Emergencies 2

Red Eye

A red eye can develop due to a number of conditions, ranging from mild self-limiting conjunctivitis to more serious sight-threatening acute angle closure glaucoma. For a definitive diagnosis, a detailed history and eye examination by a qualified professional are required. However, just the history and a phone consultation may be all that’s needed to identify when urgent medical attention is required. All eye units in the country provide a service for emergencies.

This can affect one or both eyes and is seldomly serious. It is usually caused by infection and the symptoms will depend largely on the pathogen (bug) that is causing the infection; there is generally minimal or no pain, a sticky or watery discharge and only mildly reduced vision. If itchiness of the eyes is present, the conjunctivitis may be caused by allergy. If you have symptoms of conjunctivitis, please attend your local pharmacist who will be able to advise you and potentially supply you with an antibiotic (chloramphenicol) ointment.

Redness that affects only one eye may be more serious, especially if associated with pain and/or reduced vision. Common conditions causing this include: 

A corneal ulcer is a serious and sight threating infection of your cornea, the clear window like structure at the front of your eye. The most common presentation is for a contact lens wearer to develop redness of the eye, tearing, significant pain and blurring of vision. Poor lens hygiene, sleeping in contact lenses or over-wearing may be precipitating factors. The herpes (simplex) virus, commonly implicated in cold sores, and trauma to the eye are also relatively common causes of corneal infection and ulceration. A less serious type of corneal ulcer is marginal keratitis, a peripheral hypersensitivity reaction of the cornea.

If you develop any of these symptoms, especially if you are a contact lens wearer or following trauma, it is important that you seek advice from your local optometrist, local eye unit or nearest A&E department. 

Fortunately, trauma and chemical injuries affecting the eyes have decreased over the years due to appropriate legislation and use of personal protective equipment, mainly goggles. It is not infrequent for patients to present with a chemical injury, wet plaster, liquid detergent tablets and cleaning agents being the commonest causes. A chemical injury usually causes redness, burning sensation, stinging, tearing, foreign body sensation and blurred vision.

If you do get a chemical in your eye it is very important that you immediately wash your eye out for 20 minutes with sterile saline or water, if saline is not available. This will dilute and wash out the chemical, minimising the toxic effect of the chemical. Then attend your local A&E or eye casualty to ensure the chemical has been completely removed and treatment such as an antibiotic can be started.

The most common causes of eye trauma are sports, gardening injuries, DIY and work-related injuries. Wearing goggles could prevent the vast majority of eye trauma. Minor foreign bodies in the eye, e.g. a speck of metal, can cause mild pain, sensitivity to light and watering of the eye; in larger or high impact injuries the vision can also be affected. In more serious cases, e.g. high-speed / sharp foreign body or blunt trauma with force, the injury can lead to penetration, perforation or rupture of the eye. These may require immediate surgical intervention to save the eye and vision.

If you have had an injury to the eye and your vision is blurred and / or your eye is red, painful or tearing, you should contact your local eye casualty or A&E department for advice and treatment. If your pupil is misshapen, do not apply pressure to your eye and do attend your local eye casualty or A&E department as a matter of urgency.

Flashes and Floaters

A sudden onset of flashes and floaters (black dots) in your vision requires attendance to your optometrist or local eye casualty within a day or two. The most common reason for these symptoms is a posterior vitreous detachment (PVD), where the vitreous (jelly like structure inside your eye) detaches itself from the retina due to natural ageing processes; this does not usually cause more serious long-term problems. In approximately 10% of PVD cases however, a retinal tear can develop, and this can lead to detachment of the retina. The development of an enlarging shadow or curtain effect across your vision can be a sign of retinal detachment. In the presence of a retinal tear, early laser or surgical intervention can prevent a retinal detachment and potentially permanent loss of vision.

This is a localised bleed and collection of blood in the outer white part of the eye; it can look dramatic but does not cause any significant discomfort nor long-term problems. It does not require any treatment but can take 2-3 weeks to clear. It is advisable to have your blood pressure checked and attend your GP if you are taking blood thinning medication.

Sudden Loss of Vision

Sudden loss of vision is usually vascular in origin, caused by blockage of a blood vessel or haemorrhage (bleed). The entire field of vision or only part of the vision may be affected. Usually, there is no associated pain, although in a few conditions there may be.

If you experience sudden loss of all your field of vision it may be due to a central retinal artery or vein occlusion. It is advisable to seek urgent attention at your local eye casualty. If an artery occlusion is present, early treatment has the best chance of restoring your vision; however, the outcomes for this condition are not very good and there is no convincing evidence that treatment does work. 

This represents an occlusion (blockage) of the blood supply to the optic nerve of your eye. It may affect the entire field of vision or only the top or lower half. This condition may be caused by inflammation of the blood vessels, known as giant cell arteritis; this is a medical emergency that requires urgent treatment with steroids. The majority of cases however are caused be elevated blood pressure, high cholesterol, diabetes, smoking and being overweight.

In wet age-related macular degeneration, there is a sudden onset or development over a few days of blurred central vision. This is due to leakage of fluid or blood in the central area of the retina, the macula. If you notice a blurred patch in your central vision, you should consult your local optometrist for an eye assessment and retinal OCT scan. In the presence of wet age-related macular degeneration, your optometrist will refer you to the local eye unit for review within a few weeks for consideration of treatment.

This causes a sudden reduction in vision, a halo effect in your eyesight, brow ache above the affected eye and a feeling of nausea and vomiting. The pupil in the affected eye becomes larger in size than the other eye and does not reduce in size (constrict) when a bright light is shone towards the eye. It is associated with a build-up of high pressure in your eye and usually affects individuals above the above of 55 years. If you have such symptoms, attend your local A&E department as urgent treatment is required to lower your eye pressure.

Swollen eyelid

Most cases of eyelid swelling are not serious. The most common reason is an allergic reaction; an oral antihistamine from your local pharmacy and cool compresses can rapidly improve the symptoms of itchiness. Another common cause is a blockage of the lid glands, resulting in the development of a stye or a chalazion. Should you develop a lid swelling, please attend your local pharmacy as you can be advised on further treatment options; warm compresses can encourage resolution of the stye or chalazion, but this can take weeks to months. If however you have a temperature, or feel unwell, please attend your GP or local eye casualty as oral or intravenous antibiotics may be needed.

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Hannah Gough
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Aris and team made the whole procedure from start to finish an absolute dream. All questions answered in a language that anyone could understand, more detail given when requested. Calming even during the procedure. Appointments ran fairly late, so could go outside of work hours and travel. Everything was efficient, didn't have to chase, they handled all the faff around COVID like champs. Don't forget to enter your reg number on arrival to the hospital though!
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My whol experience has been superb
I am today the morning after having completed presbyond surgery and I am absolutely delighted. The actual surgery was nothing to worry about and is completely pain free. I have spent my first night with slightly fuzzy vision and mildly gritty eyes but this really was the only side effect. This morning I opened my eyes to vision better than I can ever remember and on having my first check with Mr. Anderson it was confirmed I have 20/20 vision.
Victoria Lewis
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The ‘Gold Standard’ of laser eye surgery
Mr David Anderson is one of the leading Consultant Ophthalmologists which is why I chose him to perform my surgery. During the consultation I was very much assured that I was in good hands, but also having the ‘Gold Standard’ of laser eye surgery. It was explained that my best option was LASEK due to an eye infection rendering me contact lens intolerant. This also left me with a slightly reduced tear film... read more.
Anna Blackman
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I now have better than 20/20 vision
From start to finish, Mr Anderson and his team were wonderful!! Mr Anderson always took his time, explained every clearly and was happy to answer any questions. I now have better than 20/20 vision - and no more glasses 🙂 I would recommend Mr Anderson to anyone looking into laser eye surgery!
Lynn Farley-Rose
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I wish I hadn't waited so long
Following an injury to my cornea that never healed properly, I had phototherapeutic keratectomy. At all stages I have had the chance to ask plenty of questions and have been given balanced information. The procedure itself was done with great efficiency and professionalism from both the medical and nursing staff. Aftercare has also been good and I am entirely satisfied. I only wish I hadn't waited so long to have it done!
John Waterman
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Cannot recommend enough
The process was completely painless and quick. Any concerns you have to do with treatment whether it be the treatment itself, the aftercare... Dr Anderson will explain in detail and with patience. Also your are looked after so well by the nurses just before and after your treatment, they honestly couldn't do more to help you feel comfortable and relaxed. You are booked in for follow up treatments after your surgery and you feel like they really do care about how your eyes are and how much better your vision is, which is an incredible difference ,you feel like you aren't just a customer who they want in and out.
Graham Charlesworth
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I have been thoroughly impressed
I have been thoroughly impressed with the level of care and professionalism that Aris and his team have shown at all stages in the process. The initial assessment, the procedure itself and then follow-up consultations. Although this was something that I approached with much trepidation I am really happy with the way that it ended up and the path that I followed.

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