Ophthalmologic emergencies

What is an ophthalmologic emergency?

There are several conditions that pose an ophthalmic emergency. What they all have in common is that an urgent medical intervention is necessary to prevent or minimize permanent damage to the eye.

Among these acute conditions are retinal detachment, acute glaucoma, as well as any accident involving burns, chemical burns, or foreign bodies in the area of the eye.

Retinal detachment refers to a separation of particular layers of the retina, resulting in impaired vision and visual field loss of the affected site. The most common cause of retinal detachment is posterior vitreous detachment from its base. This may happen as part of the aging process but also in severely shortsighted people, for example.

A glaucoma describes various diseases of the eye that involve damage to the optic nerve.

One important factor in this regard is an increased intraocular pressure. During an acute glaucoma attack, the intraocular pressure increases so much that the optic nerve becomes damaged. At worst, blindness can be the result.

In principle, any kind of accident may necessitate immediate medical care. If the eye is involved, particularly quick measures must be taken to avoid a impaired vision or even blindness.

For example, burns or chemical burns may be sustained during laboratory work. Foreign bodies, among other things, can also enter the eyes in accidents during manual work, as well as in traffic or household accidents. Such accidents have to be dealt with very carefully by the first responders.

Symptoms that should alert you to see an ophthalmologist immediately

There can be a wide variety of symptoms that may indicate a medical emergency. When in doubt, you should always seek medical attention as soon as possible.  

However, in this context, certain symptoms suggest an ophthalmologic emergency.

Many acute conditions are associated with visual field loss. This involves limited vision in particular areas, which can be blurred vision, flashes of light, color changes or dark spots, for example. All of these cases require urgent medical attention. Potential causes include retinal detachment or an acute glaucoma attack.

A doctor also needs to be contacted in case of acute pain felt in the area of the eye socket. This may indicate, among other things, an acute glaucoma attack with a rapid rise of the intraocular pressure. Additional symptoms can be sensory disturbances around the face, red eyes, a changed shape of the pupil or concomitant nausea and vomiting.

In general, any sudden changes in vision or of the eye itself require prompt medical attention.

Why act quickly in case of an eye injury?

Vision represents a complicated process in which different light stimuli are converted and passed on to the brain by the optic nerve to create a visual image.

Diseases that cause an ophthalmological emergency can damage the optic nerve, affecting the entire visual process. Since nerve tissue does not regenerate at all or regenerates only very slowly, even a brief undersupply of this nerve can mean extensive damage. Therefore, it is important to initiate treatment as soon as possible in order to spare the optic nerve.

Does conjunctivitis qualify as an emergency?  

Conjunctivitis refers to an inflammation of the conjunctiva, which is the part of the eye that connects the eyelids to the eyeball. This can be brought on, for example, by bacteria, viruses or allergic reactions. 

Fortunately, in most cases conjunctivitis takes a mild course and seeing a doctor within a few days is often adequate. Therefore, conjunctivitis does not usually represent a medical emergency.

If, however, conjunctivitis is accompanied by severe symptoms like visual disturbances or severe pain, then medical attention must be seeked as soon as possible. 

Can the mind affect the eyes?

When psychological problems lead to physical symptoms, we speak of so-called psychosomatics. Physical complaints can be manifold and can also manifest themselves in the area of the eye, among other things.

Psychological distress can especially affect the autonomic nervous system and thereby foster the onset of various diseases. For instance, dry eyes, redness, but also glaucoma or impaired vision can develop.

Basically, doctors should be aware of the major effects that psychological burdens and stress can have on the body and its various organ systems. For this reason, patients' complaints should be taken seriously so that an appropriate therapy can be initiated.

Diagnosis of an ophthalmologic emergency - what is the procedure? 

According to the nature of the ophthalmologic emergency, doctors can choose from a variety of diagnostic steps.

As part of the first visit to the doctor, the eye itself should first be examined in an ophthalmologic emergency. The eyeball can be palpated carefully for this purpose. To further evaluate the situation, the doctor can check the visual field and test the light response of the pupils.

Using a so-called slit lamp, the eye can be inspected thoroughly. 

An ophthalmoscopy can be helpful to visualize the back (or fundus) of the eye and inspect the optic nerve and retina. For this purpose, eye drops are administered first to dilate the pupils. Next, the doctor can look at the base of the eye through the pupils with the ophthalmoscope.

If there is severe eye pain and headache, imaging techniques may provide information about the cause. Most importantly, bleedings or strokes in the area of the brain have to be ruled out.

Imaging, for example MRI or CT, can also be useful to identify the precise location of any foreign bodies in the eye. This is the only way to remove the object safely. In fact, this is the reason why foreign bodies should always be left in that eye until the hospital is reached.

Which doctors & clinics specialize in ophthalmic emergencies?

Ophthalmic emergencies always demand very fast and skilled treatment. Experienced doctors can prevent permanent damage and perhaps even blindness through rapid assessment of the situation and immediate therapeutic measures.

All of the ophthalmologists listed here have been carefully evaluated by us and we are convinced of their respective expertise. Take advantage of the experience of our specialists and arrange a first appointment quickly and easily.

If you're in need of a doctor, you expect the best medical care possible. So of course patients are curious to find out what clinic to go to. As there is no objective way to answer this question and a legitimate doctor would never claim to be the best, patients must rely on a doctor's experience.

Let us help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in the field of ophthalmologic emergencies and are looking forward to your inquiry or wish for treatment.

Sources:

• Amboss, Nachschlagewerk für Mediziner
• next.amboss.com/de/article/&;
• Peter Walter, Niklas Plange; Basiswissen Augenheilkunde. Springer-Verlag; 1. Ausgabe 2017