Eye emergencies: when to get help straight away

Go to an emergency unit now if you have

• sudden loss of vision, in one eye or both, even if it comes back
• a dark curtain, veil or shadow moving across your vision
• a sudden shower of floaters or flashes of light
• a chemical in the eye
• a cut, puncture or object stuck in the eye
• a hard blow to the eye, with pain, blurred vision or blood visible in the eye
• a painful red eye with blurred vision, halos around lights, headache or vomiting
• sudden double vision
• an eye that is suddenly painful, red and sensitive to light, especially if you wear contact lenses
• loss of vision with a drooping face, weak arm or slurred speech. These are signs of a stroke.
• swelling and redness around the eye with a fever, or an eye that is bulging

With eyes, hours matter. If you are not sure, treat it as urgent.

What to do first

A chemical splash

This is the one situation in which you treat first and travel afterwards.

1. Start rinsing immediately. Hold the eye open under gently running lukewarm tap water, in the shower, or pour clean water from a jug or bottle.
2. Carry on for at least 15 to 20 minutes. Roll the eye around while you rinse.
3. Take out contact lenses if they do not wash out.
4. Do not try to neutralise the chemical with anything else.
5. Then go to the emergency unit and take the container or its label with you.

Alkalis such as cement, lime, oven cleaner, drain cleaner and pool chemicals are the most dangerous, and the damage continues until they are washed out.

Something stuck in the eye, or a cut

• Do not rub the eye, press on it or try to pull the object out.
• Do not rinse an eye that may be cut or punctured.
• Protect the eye without touching it. Tape the bottom half of a paper cup over it, or use a clean eye shield.
• Do not take aspirin or ibuprofen, which can increase bleeding.
• Go to an emergency unit. Do not eat or drink on the way, in case surgery is needed.

Dust, sand or an eyelash

This is not an emergency. Blink several times, then rinse the eye with clean water or lubricating drops. Pull the upper lid down over the lower lid to sweep the speck out. If it still feels as though something is there after rinsing, or the eye stays red and sore, have it examined the same day, because the surface of the eye may be scratched.

A blow to the eye

Hold a cold pack or a cloth-wrapped bag of frozen vegetables gently against the area around the eye, without pressing on the eyeball. Get emergency help if there is pain in the eye itself, any change in vision, blood inside the eye, a pupil with an odd shape or double vision.

Welding flash or sunburn of the eye

Intense UV light from welding, sunbeds, or sun on snow or water burns the surface of the eye. A few hours later both eyes become very painful, gritty, watery and sensitive to light. It usually heals within a day or two, but it should be examined, and it is easily prevented with proper eye protection.

Urgent, but can wait until the same or the next day

See a doctor, an optometrist or an ophthalmologist within 24 hours for:

• a red, sore eye that is not improving
• a new floater or two, without flashes or a shadow
• a scratched eye
• pain when you move your eye
• a swollen eyelid that is spreading
• straight lines that have started to look wavy

What not to do

• Do not wait until morning to see whether sudden loss of vision improves.
• Do not drive yourself.
• Do not put in leftover eye drops, or anyone else's.
• Do not put a pad over an eye that may have been penetrated.
• Do not carry on wearing contact lenses in a red or painful eye.

Where to go in South Africa

• The nearest hospital emergency unit. Larger hospitals have an ophthalmologist on call.
• An ophthalmologist's rooms, during working hours. Phone and say that it is an emergency.
• Emergency numbers: 112 from any cellphone, or 10177 for an ambulance.

What a mobile optometrist is for

See Better does routine eye care: eye tests, glasses, checks for older relatives and testing at workplaces and schools. Appointments are booked in advance on WhatsApp, so we are not the right call in an emergency. Once the emergency has been dealt with, regular eye tests are how many of the conditions behind these symptoms are caught before they become urgent. See how often you should have an eye test.

For more on specific symptoms, read eye floaters and flashes and why your vision may suddenly be blurry.