Our eyes are built to be well protected from mechanical injury by their bony orbits. They naturally fight off infection through anti-microbial properties in our tear film. Our lids, lashes and blink relex are designed to provide protection from foreign bodies. Unfortunately, injuries do still occur and there are a group of conditions which are classified as sight threatening.
Optometrists are extremely well placed within the community to deal with emergencies quickly and effectively. We have the training, equipment and access to wider referral pathways to enable us to make quick decisions that can often prove to be sight saving. Many local NHS trusts have Minor Eye Conditions Schemes (MECS) in place which give rapid access to an NHS funded assessment provided by local optometrists.
Some common ocular accidents and emergencies are described below, alongside an appropriate course of action:
Ocular Foreign Bodies
Grit, dust, sand or metallic particles – we have all at some time had an ocular foreign body! They will result in a painful, red and watery eye. It is important to assess if the foreign body is superficial or penetrating. Optometrists, using a slit lamp microscope can detect and possibly remove superficial foreign bodies. Penetrating trauma will be referred on to a local eye department.
Flashing Lights and Floaters
A common presentation in optometric practice. These symptoms can often result from very natural changes within the jelly (vitreous humour) which fills the main body of the eye. Often, a posterior vitreous detachment (or PVD) is the most common cause of a sudden onset of flashing lights and / or floaters. The vitreous humour may detach from the retina, causing an area of the vitreous humour to move forward into the centre of the eye, creating the appearance of a ‘ring’ or ‘spider’ type floater. 75% of people aged over 65 will have experienced the symptoms of a PVD. No treatment is indicated. In the short term, the new symptoms can prove frustrating, however these almost always improve over time.
The early symptoms of a PVD can be very similar to those of a more serious retinal detachment. As a result, your optometrist will always want to rule out signs of retinal compromise if a patient presents with a sudden onset of flashing lights, floaters or a feeling of a ‘veil’ or ‘curtain’ in the visual field. A retinal detachment is a true ocular emergency. If detected in the early stages, treatment can stabilise the retina to prevent visual loss. Your optometrist will often dilate the pupils to gain the best possible view of the peripheral parts of the retina. Patients presenting with new symptoms of flashes and floaters should be aware that it is advisable not to drive home after dilating drops are instilled.