• Blog

24 Hour Ophthalmic Emergencies Part 2 – Swollen Lids and Ocular Trauma

• Blog

24 Hour Ophthalmic Emergencies Part 1 – Acute Red Eye

This blog summarises the assessment and initial management of common ophthalmic emergency presentation such as the acute red eye.

• Reference

Initial Assessment of the Eye

This session covers the initial assessment of eye and visual problems in the Emergency Department.

• Learning Session

Initial Assessment of the Eye

This module covers the initial assessment of eye and visual problems in the Emergency Department.

• EM Quiz

Curriculum Quiz: Ophthalmology

25 questions. 25 minutes. Test yourself against your colleagues!

• SBA

An Ophthalmic Emergency

A 14-year-old male has a painful eye following a recent insect bite to his eyelid. He has developed double vision.

• Clinical Case

An Unusual Facial Swelling

An 11-year-old female re-presenting with an unusual facial swelling.

• Induction Module

Headache – Induction

This is a hugely common presentation in the ED and often one many doctors try to avoid

• SBA

Painless Loss of Vision

A 74-year-old male presents to the ED with a recent history of painless flashes and floaters in his right eye.

• SBA

Surgical Third Nerve Palsy

A 45-year-old woman presents to the ED with a history of headache persisting for the past 4-5 days, accompanied by an inability to open her left eye for the past day.

• Clinical Case

Sight on the Line: A Paediatric Red Eye Dilemma

A 7-year-old presents with a red, painful eye following a playground trauma.

• Clinical Case

Adrenaline in a (lawyer’s) finger…

While working in the minors area of a busy teaching hospital's ED, a somewhat flustered junior doctor approaches you to confess her actions.

• Clinical Case

Photophobia and Red Eye

A 40-year-old female attends ED with a painful eye with worsening vision.

• Clinical Case

A Genuine Case of ‘Off Legs’

A 30-year-old lady presents to the ED feeling "numb from the waist down".

• Clinical Case

Help, my eye is swollen!

A child attends the emergency department with a swollen eye.

• Clinical Case

Painful Facial Rash

A 65-year-old presents with a painful rash extending to the tip of the nose.

• Clinical Case

Do unequal pupils always indicate significant pathology?

A 31-year-old female presents to the emergency department complaining of a dilated left pupil that has been noticed by a colleague at work.

• Reference

Eye Infections

Most external eye infections pose little risk to life or vision. Orbital cellulitis is the exception

• Learning Session

Eye Infections

This module will look at the assessment and management of infections affecting the external eye and the lacrimal apparatus.

• Clinical Case

Eye’ve got a terrible headache

A 72-year-old male presents with distressing peri-orbital pain after pupil dilation.

• Guideline

Management of Pain in Adults – Guideline

This guideline sets out the standards for timeliness of provision of analgesia and provides an approach to the delivery of analgesia for adult patients presenting to the ED.

• Reference

Ocular Trauma

This session covers key points in common ocular trauma scenarios that the emergency physician may encounter.

• Learning Session

Ocular Trauma

This module covers key points in common ocular trauma scenarios that the emergency physician may encounter.

• SBA

Ophthalmia Neonatorum

A three-day-old infant is brought to the Emergency Department with rapidly worsening symptoms.

• Clinical Case

Eye’m worried about my red eye!

A 28-year-old male presents with an acutely red eye and reduced visual acuity.

• Reference

Sudden Visual Loss

Sudden visual loss is a presentation one should expect and be prepared to see, as an emergency physician.

• Clinical Case

Name that Broken Bone

This 18-year-old patient was allegedly punched by a stranger during a night out.

• Learning Session

Sudden Visual Loss

Sudden visual loss is a presentation one should expect and be prepared to see, as an emergency physician.

• SAQ

Orbital Cellulitis

There's more than meets the eye in this case of orbital cellulitis.

• SBA

Acute Red Eye

Management of the most common ophthalmic presentation: the acute red eye.

• Clinical Case

Acute Headache and Visual Disturbance

A 45-year-old woman presents with 24 hour history of right sided frontal headache with progressive worsening of vision.

• Clinical Case

Curtain Call

A 70-year-old female presents with flashes, floaters, and a loss of vision in her right eye.

• Clinical Case

Eye am under pressure

A 60-year-old woman presents with eye pain and visual disturbance. She vomits just as you call her in for assessment.

• Clinical Case

Clouded Sight

A 34-year-old woman presents with a worsening vision and pain on eye movement.

• Clinical Case

Neonatal Conjunctivitis

A 10-day-old male infant presents with redness and discharge from both eyes.

• Reference

Atraumatic Red Eye

This session identifies the clinical features of the different types of conjunctivitis and describes appropriate investigation and management.

• Learning Session

Atraumatic Red Eye

This module identifies the clinical features of the different types of conjunctivitis and describes appropriate investigation and management.

• Clinical Case

Headache and Visual Disturbance

A 70-year-old female presents to the ED with headache, jaw pain and visual disturbance.

• SBA

Red Eye – Serious or not?

A patient presents with a red eye – how do you manage it?

• Clinical Case

Double Vision

A 55-year-old female presents to the ED with worsening diplopia for 2 days.

• Podcast

August 2023

This month we discuss: The STANDING Protocol for Vertigo, Head Injury (Part 2 of 2), A History of A&E Performance with Steve Black, TTA Topical Anaesthetics for Corneal Abrasion and New Online.

• Clinical Case

I think I’ve gone blind!

A 60-year-old male presents to the emergency department with sudden loss of vision in his right eye.

• Reference

Blast Injuries

This session covers the assessment, treatment and management of patients presenting to the ED with primary blast injuries.

• Clinical Case

My grandma is complaining of eye pain

An elderly lady is brought into ED with worsening left eye pain since a procedure she had to both eyes.

• Clinical Case

Bleach in my eye

How to safely manage chemical eye injury to prevent complications.

• Clinical Case

Lid Laceration

An 80-year-old woman sustains a lid-laceration in an RTC. How should this be managed?

• Blog

#PEM23

Nikki Abela and Liz Herrieven have treated themselves to the RCEM PEM Conference in Manchester on 21/3/2023 – World Down Syndrome Day. Put on your #LotsOfSocks for the day and have a read to see what they learned.

• SBA

The Red Eye

Doctor, why is my vision worse after surgery?

• SBA

Chemical Eye Burns

Chemical eye injury can be caused by acids or alkali. It is important to know how to manage them in the ED.

• Clinical Case

Vision Not Quite Right!

A 15-year-old male presents to the ED complaining of blurred vision in the right eye, floaters, and mild headache.

• SBA

Sudden Vision Loss

A 45-year-old woman presents with loss of vision in her left eye

• Clinical Case

Eye-dentify the Eponymous Signs

A 43-year-old female presents with blurred vision following a fall.

• SBA

Acute Vision and Weight Loss

It all started with a headache…

• Clinical Case

My Eye Feels Inflamed!

A 36-year-old male presents to the ED with left eye pain and ‘redness’ for one day, especially uncomfortable in bright light. He also reports blurred vision and floaters.

• SBA

Suspicious Eye Pain

A woman presents with 10/10 eye pain. Consider what could be going on, rule out the red flags and address her urgent concerns!

• SAQ

Under Pressure

A 59-year-old man presents to the ED at 11pm with acute onset severe (9/10) generalised headache and vomiting, which started at the dinner table at 5pm.

• Clinical Case

Help! My baby’s eyes are full of pus!

A 5-week-old baby presents with persistent watery pus-like discharge from both eyes.

• Clinical Case

Eye want to go home

A 2-year-old female presents to your Emergency Department after biting into a liquid detergent capsule

• Clinical Case

Eyes and Shine

A 27-year-old male presents with sudden onset of L-eye redness.

• Clinical Case

Ouch! My eye is sore!

A 63-year-old male presents with acute painful and red left eye.

• Clinical Case

Eye don’t know…

A woman presents with an unusual cause of ophthalmic symptoms.

• Clinical Case

Don’t let it cloud your vision

A 22-year-old female wakes up with photophobia, pain and irritation in the right eye.

• SBA

Eye Spy with My Red Eye

A young man presents with an acutely red and painful eye on the background of a chronic stable condition.

• Clinical Case

I woke up with a bloody eye..!

A 53-year-old man has noticed redness in his right eye this morning. He denies any pain, blurry vision or photophobia.

• Clinical Case

EYE’m in pain!

A 35-year-old woman attends the ED with right eye swelling and diplopia.

• Clinical Case

I can’t control where I am looking!

A 62-year-old man presents with sudden eye drooping and double vision.

• Clinical Case

My vision has gone double!

A 63-year-old female with no known medical history presents to the ED complaining of persistent double vision for the last four days.

• Clinical Case

Sudden Visual Loss

A 73-year-old male presents to ED with sudden, painless vision loss in left eye.

• Clinical Case

I’m Down and Out

A 54-year-old man presents with a sudden onset of double vision and a droopy eyelid.

• Clinical Case

Eye-lid you not…eye cannot move

A 5-year-old girl presents to ED with a red swollen eye which she cannot open or move.

• SBA

Seeing Double

A woman with diplopia needs your help. Can you identify the cause and include or exclude any red flags?

• SAQ

Locked in Syndrome: A Narrow Escape

A 40-year-old female is brought in by ambulance having collapsed. She has vomited several times.

• Clinical Case

All blurry visions don’t need glasses!

A young man with intermittent headache, unilateral eye strain & blurry vision.

• Reference

Kawasaki Disease

This session aims to increase the awareness of Kawasaki disease with a focus on recognising the principal clinical features, in line with recent updates to the NICE guidelines

• Learning Session

Kawasaki Disease

This learning session aims to increase the awareness of Kawasaki disease with a focus on recognising the principal clinical features, in line with recent updates to the NICE guidelines.

• Clinical Case

The Eyes Have It

A 82-year-old man attends the ED after a fall at home.

• Clinical Case

My baby’s eye is all red!

A new mum comes into your ED with her child, worried about his red eye.

• SAQ

Crash & Burn: Kawasaki disease

An SAQ designed to consolidate your knowledge on the features and management of Kawasaki disease.

• Clinical Case

In Your Face

A 30-year-old professional martial artist sustained a direct blow to the left side of his face during training.

• Clinical Case

Horny Blinder

An elderly lady, Susan, arrives in the emergency department with a sudden visual loss.

• Clinical Case

Help! I’m seeing double!

A 29-year-old lady presents with double vision

• Clinical Case

Gone in the blink of an eye: transient vision loss

A 35-year-old female presents to the emergency department with transient vision loss and headache.

• Reference

Corneal Injuries

Eye injuries are a worldwide cause of visual morbidity and account for approximately half of all ophthalmological attendances to Emergency Departments

• Learning Session

Corneal Injuries

This module covers the assessment and management of corneal injuries.

• Clinical Case

Eyelid Injury

A 31-year-old man presented to the ED after falling off a wall into a bush. He sustained head and facial injuries.

• SBA

Doctor, Eye have a Problem

A patient presents with sudden, painful loss of vision. Can you diagnose the problem and provide emergency management?

• TERN

TERN Top papers July 2021

The aim of TERN Top Papers is to highlight the top emergency care related papers for emergency physicians, keeping them abreast of the latest practice-changing studies. This month’s Top Papers comes from the beautiful hills of Snowdonia, with the team from Bangor Emergency Department bringing you this month’s summary of important articles for your attention.

• Podcast

June 2021 CPD Part B

In this episode we discuss Paediatric Cardiology, Gender identity in ED, Traumatic and Medical Ophthalmology

• Reference

Zygomatic Complex and Nasal Injury

Anyone who has ever worked in an ED on a Friday night knows that facial injuries are a common presentation

• Podcast

May 2021

This month we discuss Killer rashes-not to miss, Traumatic Eye Injury, how to distinguish Severe Drug Reactions in the ED, REBOA: What have we learnt?

• Clinical Case

Eager to Stay Optometristic

An elderly woman presents with bilateral visual loss progressively worsening over the previous four days

• Clinical Case

My eye looks wrong!

A 28-year-old female presents to the emergency department with a 3-day history of a red, painful and watery right eye.

• Learning Session

Cranial Nerves One to Six

Cranial nerve injuries are important clinical signs, which alert the examiner to intracranial pathology. This session will look at the more common traumatic and medical causes of cranial nerve injury

• Clinical Case

Giant Headache!!!

A 69-year-old lady presents with a 3-week history of right sided headache and jaw claudication, associated with significant reduction in vision of the right eye for 2 days.

• Clinical Case

An Eye-Opening Hangover

A 26-year-old woman presents to the Emergency Department complaining of unilateral headache and vomiting.

• Clinical Case

Ocular Foreign Body

A 55-year-old Farmer presented to the Emergency Department with sudden onset decreased vision, pain and bleeding from his right eye.

• SAQ

Popping Out

It's a busy Friday night in the emergency department and another facial injury presents following an alleged assault to the right eye.

• SAQ

Blind as a Bat

When a simple trip makes you as blind as a bat.

• Blog

Sight for Sore Eyes

Eyes are the windows to the soul. They have the power to mesmerise and enchant even the hardest of hearts. Yet, for many clinicians, they also instill genuine fear.

• SAQ

More than meets the eye?

A previously healthy 28-year-old male accountant presents to the ED with pain in his left eye.