Your Guide to Evaluation During the Pandemic
Hi I'm Julia Haller – Ophthalmologist-In-Chief here at Wills Eye Hospital. This is a scary time for us all. We know it can be overwhelming to decide when it may be necessary to seek an eye evaluation in this critical time of self-isolation. As we continue to do all we can to connect with our patients we wanted to share with you how you can maneuver getting an exam when needed, and things which we consider to be eye emergencies that should prompt you to seek assessment. In this video, my colleagues and I will discuss emergent situations in our fields. We are going to do our best to cover all we can in the next few minutes, but if your condition is not discussed please reach out so we can help navigate your specific situation.
Hi, I am Dr. Aaki Shukla from the Wills Glaucoma Service, and I will be discussing the signs and symptoms of eye emergencies. These commonly include, but are not limited to: decreased vision, pain in or around the eye, sensitivity to light, distortion of vision, new double vision, a curtain coming down over the vision, flashes of light, and many new floaters. If you have had eye surgery and are experiencing worsening eye pain, decline in vision, or copious discharge from the eye, you should undergo prompt evaluation for an eye infection. If you suffered from an eye injury and are experiencing vision changes, eye pain, change in the shape of your pupil or in the color of your eyelid, please seek care as soon as possible.
Hi my name is Dr. Alison Watson from the Oculoplastics and Orbital Surgery Department at Wills Eye Hospital. We treat structures around the eye, including the eyelids, eye muscles, and eye socket. Some concerning signs and symptoms that require prompt ophthalmic evaluation include the new development of swelling around or behind the eye, pushing the eyeball forward, pain, decreased vision, or double vision. These can be signs of a serious eyelid or orbital problem. Any trauma to the eye region warrants urgent evaluation, as you could have bleeding behind the eyeball, broken orbital bones, lacerations of the eyelids, or injury to the eyeball itself. Lastly, while changes in the appearance of the eyelids is often associated with aging, a sudden drooping of the eyelid, asymmetry in the pupil size, or sudden onset double vision can all be signs of a serious neurologic problem should be evaluated emergently.
Hi, my name is Dr. Zeba Syed from the Wills Eye Cornea service. The cornea has the most densely packed nerves in any part of the body, and therefore even small corneal problems can cause significant pain. Circumstances that require emergent attention include, first, any history of trauma to the cornea. For example, pain after a fingernail scratch to the eye may be a corneal abrasion that should be evaluated to rule out any developing infection. Foreign bodies, such as from outdoor work, should also be immediately addressed. Any pain, redness, or discharge related to contact lens wear should be taken seriously, as infection is more common among contact lens wearers. In these days of heightened hygiene, many of us are using household cleaners more frequently, and any splash to the eye that causes pain for more than a few minutes should be considered an emergency. Finally, if you have a history of a corneal transplant, worsening pain or light sensitivity should be taken seriously as it can signal rejection or a broken suture, which is an infection risk.
Hi My name is Dr. Natasha Nayak Kolomeyer, and I am one of the glaucoma specialists at Wills Eye Hospital. Beyond the symptoms already discussed, there are several specific types of glaucoma emergencies.
#1. Acute angle closure glaucoma - signs of this can include a severe ache around the eye with blurry vision and light sensitivity, and at times nausea/vomiting.
#2 If you have had a history of glaucoma surgery and now have sudden change in vision, redness, eye pain, crusting, or discharge, this could signify an emergency such as an infection.
#3 Very high or low eye pressure can be an emergency and if you were being followed closely for this reason, it warrants continued close follow up.
Notably, if you are having any issues with using your glaucoma eye drops, such as inability to get refills from a pharmacy, please communicate this with our office as soon as possible.
Otherwise for existing patients whose appointments were not urgent and therefore postponed, we recommend making the most of our telehealth video consultation to discuss your glaucoma care.
Hi, my name is Dr. Jade Price from the Wills Pediatric Ophthalmology Service. It can be very difficult to know when a child is having an urgent vision problem. If you have any concerns about your child’s eyes or vision, please email us directly at firstname.lastname@example.org. We are here to serve you with in person consultation for emergencies as well as telehealth consultation for other concerns. Emergencies include sudden changes in vision, an abnormal red reflex in the eye, trauma to the eye, or a new diagnosis of uveitis or glaucoma. For these diagnoses, we recommend they come urgently to our clinic for an in person exam. Other problems such as bumps on the eyelids, pink eye, tearing, or a lazy eye, would be best managed with telehealth consultation.
Hi I am Julia Haller of the Retina Service here at Wills Eye Hospital. The retina is the nerve layer in the back of the eye that senses light and converts it into signals that can be processed by the brain. Retinal emergencies can include detachment of the retina, bleeding under, within, or in front of the retina, inflammation of the retina, blockage of the vessels that supply the retina with oxygen, and more. Signs of a retinal emergency include vision loss, a curtain coming down over the vision, flashes, many new floaters, distortion of vision, or severe eye pain and decreased vision after any type of surgery.
If you think you need to make an urgent in person appointment please call us to schedule. For concerns about your health in the current crisis you can reach us via email at: email@example.com. If you are not sure if your case constitutes an emergency or requires an in person visit, we have telemedicine options and we can meet and discuss virtually. Finally, if you are showing signs of a true eye emergency, please visit your nearest ER or we are here to help 24 hours a day at the Wills Eye Emergency room, staffed with our wonderful resident physicians. We are here for you and your families, and we will get through this challenging time together.