Eye emergency

Noor hospital has established the first eye emergency among private hospitals and clinics. Services are provided 24/7 in this emergency room for the patients and specialist advice is provided for other clinics by an ophthalmologist. In this center, all outpatient services are provided including removal of foreign body, superficial sutures, medical treatment and patient follow-up until achieving a satisfactory result.

Eye emergencies are referred to eye diseases or problems that have occurred acutely over the past 24 to 48 hours and caused vision loss, pain, redness, burning, diplopia, and bulging eye. Fortunately, in eye emergencies, except for a few cases, there is no need for immediate intervention and treatment can be done with several hours delay. If patients have urgent conditions in other organs, or they have a decreased level of consciousness (e.g., in accidents), it is vital that those problems be addressed, such as treatment of internal bleeding, then they be transferred to eye center for eye problems.

On the whole, ophthalmology emergency patients can be divided into three general categories:

  • Emergency patients with eye trauma;
  • Emergency patients without eye trauma, such as blurred vision, pain or redness;
  • Patients with emergency problems after surgery (post-op patients)

For the first time in the country's private hospitals and clinics, ophthalmology emergency has been established by Noor Hospital. The services are provided 24 hours in this emergency for patients and specialist advice is provided for other clinics by an ophthalmologist. In this center, all outpatient services are provided including removal of foreign body, superficial sutures, medical treatments and patient follow-up until achieving a satisfactory result. After the initial examination, patients who require hospitalization and surgery will be prepared for surgical operation on the same day or the day after by physician’s discretion and after putting an eye shield and prescribing necessary medication. Additional surgical procedures can be performed and consultation with subspecialty services can be provided, if needed, and all facilities and equipment associated with the services are available in Noor Hospital.

Furthermore, people who have severe eye problems and cannot go to the emergency clinic can call our telephone counseling service to make appointments 24/7.

Noor Eye Hospital hopes that as the only private ophthalmology emergency, it can provide appropriate services to eye patients and other medical centers and hospitals.

Chemical burns: Burn caused by chemicals entering the eye is considered an ophthalmology emergency and requires immediate intervention. The delay in initiating treatment will cause severe and irreparable damages to the eye. The first thing to do in such a case is to rinse the eye with copious amounts of water on the scene and then transfer the patient to the ophthalmology center. The rinse can be done with any water available such as tap water and bottled water. It should be noted that eyes should never be rinsed with alkali or acid to neutralize the acid or alkali. For example, to neutralize acidic chemical burn, alkaline material should not be poured in the eye, as it can cause further damage to the eye. It is noteworthy to know some hazardous materials that are readily available to people and can cause severe burns, including detergents and bleaching agents and pipe cleaner powders. So, precautions should be taken when using such materials.

Thermal burns: Treatment of thermal burns is similar to chemical burns and the first step of treatment is to wash the eye with plenty of water and complementary treatments are performed by an ophthalmologist. Here, ocular injuries associated with combustible materials, firecrackers etc should be cited. Every year, they cause severe permanent damages and bilateral reduced vision near Charshanbe Soori (the last Wednesday night in Persian Calendar), so it is advised to avoid such materials.

 

Eyelid and facial lacerations: If there is bleeding, it can be stopped by applying direct pressure using the sterile gauze. If the eyelid is torn and there is a possibility of rupture of the eyeball, such as piercing sharp objects, direct pressure on the eyeball should be avoided and a protective eye shield should be used and the patient should be transferred to an ophthalmology center.

 

Rupture of the eyeball: In such cases any manipulation of the wound and administering any eye drops should be avoided and a protective eye shield should be used. Eye dressing should be avoided and the patient should be transferred to an eye center to be examined by an ophthalmologist, so required treatments can be performed, which sometimes include hospitalization and surgery. If an object like ice has pierced the eye and remained there, avoid any manipulation to remove it and transfer the injured in the same condition to the hospital.

 

Foreign body on the surface of the eye: If a foreign body such as dust, eyelashes and the like enters the eye, at first wash the eye with water and in case the object could not be removed from the eye, go to an ophthalmologist and avoid further manipulation of the eye to prevent further damage to the eye. If a foreign body hits the eye while hammering, go to an ophthalmologist as soon as possible. In penetrating injuries caused by needle of syringe (especially in children) despite their normal appearance, there is the possibility of severe intraocular infection and loss of vision, so the patient needs to visit an ophthalmologist.

 

Blunt trauma (non-penetrating trauma) of eyelid and eyeball:

Like punch and heavy objects that do not cause apparent rupture. In such cases, the patient is better to be examined by an ophthalmologist and then the required treatment can be performed because sometimes there are hidden tears in eyeball or sometimes there is bleeding behind the eyeball caused by trauma leading to protrusion and hardening of the eyeball and there is need for urgent intervention, as delay will cause permanent damage to eye and the optic nerve. In cases such as simple internal bleeding of the eye, the ophthalmologist attempts to administer the required drugs after examining and making sure that there is no further damage such as tear of eyeball or retinal detachment or damage to the optic nerve.

 

Damage caused by welding (UV-Keratitis): In such cases, the ophthalmologist will dress the eye and prescribe the required drugs after examining and making sure that there is no foreign body on the surface of the eye. This state is caused not only after welding, but after skiing or walking in snow without sunglasses. Using anesthetic drops is not recommended at all because of the risk of creating corneal ulcers.

Superficial eye infections (conjunctiva): Symptoms of these infections include redness, tearing, purulent discharge and sticky eyelids. Most of these infections are in both eyes or will finally infect both eyes. They are contagious and there is possibility of transmission from a patient to healthy people with contact such as shaking hands, kissing, using common towels etc. In these cases, the patient should be also examined by an ophthalmologist so that necessary treatments will be prescribed. In some cases such as neonatal conjunctivitis further treatments and sometimes hospitalization are needed. In case of corneal infections that harbor pain and decreased vision in addition to above symptoms, it is necessary to prescribe medications. The delay in initiating treatment of corneal infections will cause spread of infection into the eye and severe loss of vision.

Infections in eyelids and around the eyeball and tear ducts: These infections can be either a simple sty with swelling and redness of eyelids or more severe infections of eyelids that will lead to spread of infection into the eye socket, which can sometimes be life threatening. Sometimes eyelid infections mandate hospitalization, especially in children under 5 years old, and administration of intravenous drugs. In these cases, the patient is better to be examined by an ophthalmologist and then necessary treatments will be prescribed.

Sudden vision loss: Sudden vision loss (within a few minutes) is often associated with ocular vascular occlusions that should be immediately referred to an ophthalmologist as in some cases such as central retinal artery occlusion immediate treatment may restore vision to some extent. In cases that vision loss may occur within hours to days, there is need to visit an ophthalmologist as soon as possible as in some cases such as retinal detachment, timely treatment can prevent progression and further damage to the eye.

Pain and redness of the eyeballs: These cases can sometimes be caused by a harmless problems such as simple subconjunctival bleeding (on the white part of the eye), which is redness without pain, burning and loss of vision and usually resolves spontaneously within a few days, or due to a serious problem that requires an immediate intervention such as acute glaucoma that eye redness is accompanied with pain, headache, nausea, vomiting and loss of vision. Emergency intervention is necessary for lowering eye pressure to prevent further damage to the eye and the optic nerve. In case of uveitis (inflammation inside the eye) in addition to eye redness, the patient suffers from pain, photophobia and eye sensitivity to touch. So it is better that in these cases the patient is also examined by an ophthalmologist.

It should be understood that eye surgeries either intraocular such as cataract surgery or superficial eye surgery such as LASIK or LASEK like any other surgery have low risk of infection and other complications, and are particularly important in the first to second week after the surgery. So in case of severe pain, redness, decreased vision or eye trauma after surgery, it is necessary to go to Noor Hospital for the required treatments after calling and making necessary coordination. The delay in the treatment of some cases such as intraocular infections after intraocular surgery as in cataract will lead to irreparable damages to the eye. In some cases such as nose bleeding after surgery on the tear ducts, first try to reduce bleeding by applying ice bags on the head and the surgery site and using sedatives, and if it is not controlled, go to the hospital. It should be understood that in surgery on tear ducts, small amounts of bleeding from the nose and throat is quite normal for several days after surgery.