Ophthalmological emergencies

It is impossible to predict where your medical career will take you. Ophthalmological problems can occur in any setting, whether it be in a clinic, on a hospital ward, in the casualty department, or in a general practice. In a general casualty department, more than one in 20 attendees presented with eye complaints.1 Therefore, all students and junior doctors should acquire key skills in assessing someone with an ophthalmological problem. These include an ability to take a history, measure visual acuity, and elicit clinical signs, such as an afferent pupillary defect. Most ophthalmic problems will cause no permanent damage if left until the eye emergency department opens the next morning. This article describes the conditions that can impair vision, or worse, result in blindness (table).

The signs of anterior ischaemic optic neuropathy are a swollen optic disc and a relative afferent pupillary defect (see box). As well as loss of