"Top Ten" Eye Emergencies: Part 1

05 Feb "Top Ten" Eye Emergencies: Part 1

Any vision loss can be scary.  Sudden vision loss is even more frightening.  There are really only a couple of “true” retinal eye emergencies.  I’ve listed the “top ten,”  remember that there are many ways to define an emergency.  All involve loss of vision, or at least a change in vision, and that alone probably qualifies as an “emergency.”  By the way, if you have sustained any of these symptoms, please call your doctor.  This article, and web site, is not intended to replace medical advice.

So here goes;  my “Top Ten” Retinal Emergencies;

10.  Vitreous hemorrhage – the symptoms of a vitreous hemorrhage can range from the onset of sudden floaters to rather impressive loss of vision, depending upon the amount of bleeding into the vitreous.

• Causes – retinal tear, proliferative diabetic retinopathy
• Concerns – an undiagnosed tear can lead to a retinal detachment
• Comments – blood in the eye is not toxic, the blood is physically blocking light from hitting the retina

9.  Vascular Occlusions – either vein occlusions or artery occlusions.  Patients experience sudden loss of vision.

• Causes
• Vein Occlusions – may be associated with hypertension or diabetes, often healthy individual
• Artery Occlusions – look for cardiovascular disease/stroke
• Concerns – may develop “neovascular” glaucoma
• Comments – treatments include laser treatment, Ozurdex (vein).

8.  Submacular Hemorrhage – sudden bleeding underneath the macula/retina.  Causes a dark area in the vision.  Usually the peripheral vision is normal.

• Causes – valsalva, trauma, macular degeneration
• Concerns – source of the bleeding
• Comments – valsalva (aka straining) has the best prognosis, remember blood underneath the retina is not toxic

7.  “Wet” Macular Degeneration – rapidly (days to weeks) decreasing vision, distortion.

• Causes – fluid/blood accumulating in the macula
• Concerns – look for abnormal blood vessels (neovascularization)
• Comment – fluorescein angiography is helpful

6.  Uveitis/Iritis – this is inflammation inside the eye, not unlike arthritis.  Patients may experience pain, sensitivity to light, decreased vision.  Eye may turn red.

• Causes – endogenous, some rheumatologic diseases, trauma
• Concerns – relief of pain, may look for associated systemic disease
• Comment – usually steroids play a big role in controlling this

To Be Continued…