Urgent Eye Care: Protocols for Handling Common Eye Emergencies

Juggling routine eye exams with unexpected emergencies is inevitable for most optometrists. Here’s a breakdown of protocols for handling some common eye emergencies you might encounter, empowering you to deliver top-notch care, no matter the ask: 

  1. Corneal Abrasions: Corneal abrasions are among the most frequent eye injuries, often resulting from foreign objects like dust or contact lenses. Patients typically present with severe pain, tearing, and photophobia. Immediate action includes thorough irrigation to remove any foreign material, followed by fluorescein staining to confirm the diagnosis. Prescribing antibiotic eye drops can prevent infection, and recommending lubricating drops can enhance comfort during the healing process.
  2. Acute Glaucoma: Acute angle-closure glaucoma is a sight-threatening emergency. Patients often report sudden onset of severe eye pain, headache, nausea, and halos around lights, accompanied by decreased vision. It’s vital to measure intraocular pressure (IOP) promptly; elevated IOP confirms the diagnosis. Initial treatment includes medications like oral acetazolamide and topical beta-blockers to lower IOP. Immediate referral to an ophthalmologist for further management, possibly including laser therapy, is critical.
  3. Retinal Detachment: Retinal detachment can lead to permanent vision loss if not treated swiftly. Symptoms often include sudden flashes of light, a dramatic increase in floaters, or a shadow over the visual field. Approximately 1 in 10,000 people are affected by retinal detachment annually. Prompt dilated fundoscopy is critical for diagnosis. If detachment is suspected, urgent referral to a retina specialist is necessary for potential surgical intervention.

Bonus Tips for Optometric Emergencies 

  • Preparedness: Keep a well-stocked emergency kit with fluorescein strips, topical anesthetics, antibiotics, and cycloplegic drops. 
  • Training: Regularly update your skills through continuing education courses focused on emergency eye care. 
  • Patient Education: Inform patients about the importance of seeking immediate care for sudden vision changes, pain, or trauma.  
  • Network: Build a strong referral network with local ophthalmologists and emergency departments to ensure swift collaboration when necessary. 

By following these tips and building your confidence in handling urgent eye care situations, you can become a valuable resource for your patients and a key player in safeguarding their vision.  

SOURCES: AAO