Emergency primary eye care. Tips for diagnosis and acute management

Acute eye problems are among the commonest problems presenting to the general practitioner. Due to the general lack of exposure to such problems and unavailability of appropriate equipment, the diagnosis is difficult to make with any degree of certainty. The availability of eye services varies widely in Australia. In urban centres the GP has greater access to ophthalmic services. In regional Australia, the practitioner may need to rely more on his or her own findings and experiences.

This article aims to equip the GP with an outline of the clinical findings as well as an approach to acute management of the commonest presenting problems. In many cases, initial treatment will serve to minimise morbidity, before treatment can be delivered by an ophthalmologist.

I have divided the commonest problems that may need urgent attention into three groups: acute red eye; trauma; and sudden visual loss. This list is not intended as an exhaustive presentation of ophthalmic problems, but rather an outline of conditions where prompt diagnosis and treatment by the GP can positively affect the outcome.