Eye Emergencies Includes

•  Chemical exposure.
•  Eyeball scratches.
•  Eyelid cuts.
•  Foreign body in the eye/ object stuck in the eye.
•  Diseases.
•  Burns. 
• Cuts and Blows to the eye.

The primary medical emergency involving the eye is glaucoma. Sudden painless loss of vision secondary to arterial embolus is another treatable medical emergency.

Eye injuries can be chemical or thermal burns, penetrating or blunt trauma which can result in permanent disfigurement and/or blindness.

In addition small foreign particles landing on the surface of the eye can also result in ocular emergencies.

Common symptoms :

·        Cut or bruise on eye              ·       Pain in or around eye     ·       Bloodshot eye

·        Dry or itchy eye                       ·        Tears                                ·        Rapid blinking

·        Inability to keep eye open     ·        Sensitivity to light         ·        Impaired vision

·        Headache                                  ·        Unequally sized pupils

• In normal routine, the eye will clear itself of a tiny object like dust through blinking and tearing. If not, here are some first aid measures:
• Do not rub the eye. Wash your hands before examining the eye. 
• Examine the affected eye in a well-lighted area. To find a foreign body, have the victim look up and down and then side to side. 
• If you can't find the object, grasp the eyelid and gently pull down on the lower lid to expose the fold between the eyelid and the globe of the eye. If necessary, pull up on the upper lid. 
• If the foreign body can be seen on the inner surface of either the lower or upper lid, try to gently flush it out with water or lift it off with a clean cloth (not a cotton swab or tissue). 
• If the foreign object is embedded in the eyeball, cover the patient’s eyes with a sterile pad or clean cloth. Do not try to remove the object. Get medical help. 
• If you cannot locate the foreign body, or if you remove it but the victim still has discomfort or blurred vision , cover the victim's eyes with a sterile pad or clean cloth. Get medical help. 

• Leave the object in place. Do not touch it or apply any pressure to it. 
• Wash your hands. 
• Calm and reassure the patient. 
• Bandage the eye. If the object is large, place a paper cup or cone over the injured eye and tape it in place. If the object is small, cover both eyes with a clean cloth or sterile dressing. 
• Try to keep the victim calm and quiet until you have medical help.

Foreign bodies can become trapped underneath the upper eyelid and repeatedly scratch the cornea with eyelid blinking . Equally common , foreign bodies may become embedded in the cornea .

An ophthalmologist may  evert ( flip inside out ) your upper eyelid and sweep the surface of the eyelid with a cotton-tipped applicator . Embedded corneal foreign bodies can be removed with the tip of a small needle while the eye is anesthetized with a topical anesthetic eye drop . Antibiotic ointment and a pressure patch may be applied to the eye overnight .

• Accidents 
• Occupational injuries
• Sports injuries
• Fights. 
• Certain types of skull fractures can result in bruising around the eyes, even in the absence of direct trauma to the eye(s). 
• Bleeding under the skin causes a bruise and the discoloration associated with it. The tissue surrounding the eye turns black and blue, then gradually becomes purple, green, and yellow before the abnormal coloring disappears within 2 weeks. Usually, swelling of the eyelid and tissue around the eye occurs as well. Occasionally, serious damage to the eye itself occurs. Recurrent bleeding within the eye can reduce vision, cause glaucoma , or damage the cornea. 

In the case of a ' blowout fracture', the eye may be intact  but  a momentary , sudden increase of intra-orbital pressure may cause a fracture of the bones supporting the orbit , leading to entrapment of orbital tissue - causing eyelid droop and double vision . This may require surgical treatment.

Blunt trauma can injure the retina by creating retinal tears which may lead to a retinal detachment in the future . Also, bleeding into the vitreous jelly may occur which will blur vision . Retinal hemorrhage and retinal bruising can happen. Infrequently , the optic nerve itself is damaged by blunt trauma .

Blunt trauma can affect the anterior portion of the eye also . Bleeding from a torn iris blood vessel in the front of the eye is termed  hyphema . If a  hyphema is present , a future eye exam may need to be scheduled to rule out a late-term complication called  angle-recession glaucoma.

Blunt injury to the eye may break small blood vessels under the conjunctiva (the clear membrane that covers the eye), creating red areas on the white of the eye. Such bleeding is usually minor and does not require emergency care; but can visit ophthalmologist  for advice.

• Cover both eyes with a clean cloth and take the victim to the nearest hospital. 
• If there is bleeding from inside the eye, elevate the victim's / patient's head above his heart, cover both eyes with a clean cloth and take the victim to the nearest hospital.

• If the eyeball has been injured, get medical help immediately. 
• Gently apply cold compresses to reduce swelling and help stop any bleeding . Do not apply pressure to control bleeding. 
• If blood is pooling in the eye, cover both of the victim's eyes with a clean cloth or sterile dressing and get medical help immediately.

• If the cut is bleeding, apply direct pressure with a clean, dry cloth until the bleeding subsides. 
• Rinse with water, cover with a clean dressing, and place a cold compress on the dressing to reduce pain and swelling. 
• If the cut is more than several millimeters, or if the cut goes across the edge of the lid, get medical help.

• A penetrating eye injury may lead to a significant corneal laceration or a ruptured globe . 
• No pressure should be applied to a suspected ruptured globe.
• A ruptured globe requires immediate attention by an ophthalmologist and may require emergent surgical repair.
• A ruptured globe with iris tissue prolapsed through a corneal laceration.

Arc-welding corneal flash burns are the result of looking at the flame of an acetylene torch without proper protective eye wear or shields. The bluish flame emits an intense ultraviolet light which can cause a sunburn and corneal flash burns. (Snow-blindness occurs similarly as a response to natural ultraviolet light reflecting off snow .) 

Corneal flash burns represent a superficial epithelial keratitis in response to ultraviolet light. The discomfort from corneal flash burns may not be immediate and may take more than 12 hours to develop.

• A corneal flash burn can be intensely painful. The eye pain will generally resolve within two to three days. 
• Other symptoms include redness, tearing, light sensitivity, and blurred vision. 
• Corneal flash burns will heal without any long-term damage .

• Take advise from an ophthalmologist.
• Prescription oral pain medications are often necessary.
• Patching the eyes can also provide some comfort .
• Cold compresses and frequent use of viscous artificial tears can be helpful .
• Sometimes , a topical steroid eye drop can help relieve the associated       inflammation.
• Flush the eyes with cool water (unless it is painful to do so) to reduce swelling and to help relieve the pain. 
• Apply a cool compress to the eyes but avoid applying pressure. 
• If there is swelling in or around the eyes, or if there are visual problems , get medical help.

• Eye pain may be severe . 
• Blurred vision .
• Tearing.
• Some redness .
• Light sensitivity .

• An antibiotic ointment will be applied to the eye followed by a pressure eye patch overnight or for a few days to relieve eye pain and assist healing .
• Prescription pain medications may also be necessary for the first few days.

Endophthalmitis refers to an intraocular infection . Rarely , endophthalmitis can develop spontaneously .  Endophthalmitis is a very serious eye emergency . Time is of the essence to recognize and treat this condition . Pus inside the the eye may suggest the diagnosis of endophthalmitis to your ophthalmologist. 

Vision can quickly deteriorate permanent blindness within a few hours of time . Any post-operative patient who feels that he is not recovering from surgery in a routine fashion should immediately contact his ophthalmologist.

• Rapid deterioration of vision . 
• Increasing visual floaters .
•  Increasing redness . 
•  Increasing eye pain .

One spontaneous cause of a red eye which is generally seen in middle-aged , or more commonly , elderly adults , arises from an uncommon form of glaucoma termed  narrow-angle glaucoma attack  . 

While most forms of glaucoma do not cause eye pain , this form of glaucoma does cause a severe , boring eye pain .

• Appearance of a red eye with eye pain . 
• Eyebrow aching pain . 
• Blurred vision .
• Seeing halos around bright lights. 
• Nausea and Vomiting.

During a narrow angle glaucoma attack , the intra ocular fluid pressure rises precipitously and dangerously high ; this represents an ocular emergency . 

A narrow-angle glaucoma attack may be precipitated after the use of dilating eyedrops , therefore any patient who has had a dilated eye exam and within 6 - 12 hours later ,experiences these symptoms , should immediately contact their ophthalmologist .

Retinal artery occlusions can involve either the central retinal artery or smaller branch retinal arteries . Retinal artery occlusions are one cause of sudden , painless vision loss in one eye .

More commonly , retinal arterial occlusive disease is associated with  hardening of the arteries ( atherosclerosis ) or valvular heart disease or prosthetic heart valves . Blood clots can form on diseased arterial walls or diseased heart  valves , and small pieces of clot can break off and float in the bloodstream ,  until they become lodged in retinal arteries . 

Similarly , cholesterol plaque formations on the walls of diseased carotid arteries in the neck may break off and flow through the bloodstream until they become lodged in smaller retinal arteries .The arrow points to an embolised solid fragment of cholesterol that has broken of from the wall of the carotid artery in the neck , floated in the bloodstream - like a log in a river- until it got caught in a small artery in the retina - a" Hollen-horst plaque". 

Patients may experience transient , recurrent visual loss symptoms as a precursor for a major event with resulting permanent visual loss from an arterial occlusion . Transient visual loss with darkening of vision in one eye lasting generally a few minutes or less than one hour is termed ' amaurosis fugax ' or ' transient visual obscurations ' . Episodes of amaurosis fugax may be a warning symptom leading up to either blindness from a full-blown arterial occlusion or a cerebral stroke or a heart attack .

A normal macula and optic nerve .A central retinal artery occlusion if seen within the first few hours or days may have this appearance . The retina is pale due to retinal swelling and poor blood flow ; the optic nerve is also pale and swollen , and the fovea appears more prominent and is called a ' cherry red spot '.