Context

Eye problems contribute to a substantial proportion of the emergency physician’s (EP’s) workload. Even in regions with dedicated ophthalmic casualty units, more than 30% of patients with eye problems will continue to seek help via non-specialist local emergency departments (EDs). [1] Roughly 50% of attendances with eye problems are atraumatic and sudden visual disturbance amounts to over 10% of these cases. [2, 3]

Most cases of sudden visual loss are caused by serious underlying pathology and need prompt diagnosis and early treatment if vision is to be salvaged. Although specialist ophthalmological assessment is usually needed, it is important that the EP takes a thorough history and performs a comprehensive examination to make an accurate diagnosis. Treatment can often then be instigated as a matter of urgency, potentially preserving the patient’s sight.

Learning bite

More than 30% patients with acute eye problems will self refer to non-specialist EDs, and a significant proportion of them will have a sudden visual loss. Prompt diagnosis via comprehensive assessment and early treatment is essential for the majority of pathological causes.