Q: How do I know when my eye problem is an emergency? When should I self-treat, go to my eye doctor, or head to Emergency?
A: It's always hard to know whether or not an eye problem is an emergency, but there are a few red flags that people should watch for.
First and foremost, and not surprisingly: if you suddenly can't see out of one eye, you should go to the Emergency room right away. Sudden blindness may mean you have a blocked artery in the blood vessels that lead into your eye (called a central retinal artery occlusion). A blocked artery usually won't cause any pain, but can lead quickly to severe vision loss. If this problem is discovered early, the blood clot can be dissolved, which could save your sight.
Sudden vision loss (whether total or partial) in one eye could also be caused by a detatched retina, or by retinal bleeding from wet AMD (age-related macular degeneration). Both of these conditions can be treated more effectively if seen early, so at the first sign of vision loss, head to Emergency right away.
If your eye becomes very painful in a matter of hours, this is another red flag. You may have acute closed angle glaucoma, which causes high pressure in the eye and can lead quickly to serious vision loss. If you have this form of glaucoma, your eye will be red and feel hard. You need to be seen in the Emergency room immediately to receive medicine to lower the pressure in your eye.
Sudden and extreme sensitivity to light (photophobia) is another danger sign. Severe light sensitivity, often coupled with eye pain, can mean you have iritis, an inflammation of the front of the eye. Although iritis is a serious condition that can lead to other eye diseases, it can be treated with steroids if caught early.
Any kind of trauma to the eyes should be looked at right away. If your eye has been struck by an object of any kind, it needs to be assessed to make sure that you don't have intraocular bleeding or scratches on your cornea.
Set Your Sights on a Doctor
If you have an eye problem, but you are not experiencing sudden vision loss, eye pain or light sensitivity, and you are fairly certain you haven't gone through any kind of eye trauma, you are safe to make an appointment with your eye doctor to get the problem diagnosed in a few days. For instance, if your eyes become terribly itchy, you may have the allergic form of pink eye. Your doctor can prescribe anti-allergy medicine to get rid of the itch.
Keep an Eye Out for Yourself
There's at least one instance in which you can safely self-treat an eye problem. If your eyes are red but not itchy and you have symptoms of a cold, but you don't have blurred vision, pain, or oozing secretions, you may have a case of viral pink eye. You can safely stay at home until the redness goes away. However, if you don't improve within a few days, you should see your doctor.
Dr. Bruce Jackson, MD, FRCSC, is a professor and chair in the Department of Ophthalmology at the University of Ottawa, and is director general at the University of Ottawa Eye Institute.