Ophthalmic EmergenciesSudden painless vision loss (TIA/retinal artery occlusion — 90 min window), painful red eye with fixed pupil (acute glaucoma), eye trauma, chemical injury, or new flashing lights + floaters + curtain across vision (retinal detachment) — attend A&E or emergency eye unit immediately.
Common Eye Symptoms & Their Causes
| Symptom | Common Causes | Urgency |
|---|---|---|
| Sudden painless vision loss | Retinal artery/vein occlusion, AION, vitreous haemorrhage | Emergency — within 90 minutes (artery occlusion) |
| New floaters + flashing lights | Posterior vitreous detachment (PVD) or retinal detachment | Same-day assessment |
| Painful red eye | Acute angle-closure glaucoma, corneal ulcer, iritis/uveitis | Emergency or urgent (same day) |
| Gradual painless vision loss | Macular degeneration (AMD), glaucoma (peripheral first), cataract | Routine ophthalmology |
| Double vision (diplopia) | Cranial nerve palsy (3rd, 4th, 6th), thyroid eye disease, MS | Urgent neurology if new |
| Watery, gritty, red eye | Viral or bacterial conjunctivitis, dry eye, allergy | GP or pharmacist |
Wet vs Dry AMD
Age-related macular degeneration (AMD) is the leading cause of blindness in over-65s. 'Dry' AMD progresses slowly — AREDS vitamins slow progression. 'Wet' AMD (neovascular) causes rapid vision loss — anti-VEGF injections (ranibizumab, bevacizumab) stop progression and can restore vision if treated early.
Annual Eye ExamAnnual optometry review is recommended for everyone over 40, diabetics, those with family history of glaucoma, and people with high prescriptions. NHS eye tests are free for over-60s, diabetics, and glaucoma risk patients.
What causes flashing lights and floaters?
Most commonly posterior vitreous detachment (PVD) — the gel inside the eye liquefies with age and pulls away from the retina. Usually benign, but 10–15% of PVDs cause a retinal tear or detachment — same-day assessment is essential for all new symptoms.
Is glaucoma curable?
No — but it's very manageable with early treatment. Glaucoma damages the optic nerve from raised intraocular pressure. Once nerve damage occurs, it's permanent. Regular eye pressure monitoring and eye drops (or laser/surgery) prevent progression.
Can diabetes affect eyesight?
Yes — diabetic retinopathy is the leading cause of blindness in working-age adults. It causes new blood vessel growth (proliferative retinopathy) and macular oedema. Annual retinal screening and tight glucose/BP control prevent it.
What is a corneal ulcer?
A painful, vision-threatening infection of the corneal epithelium — usually bacterial (contact lens wearers at risk), but also viral (HSV), fungal, or amoebic. Urgent ophthalmology assessment and topical antibiotics required.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.