Management of ocular emergencies and urgent eye problems

Evaluation of the patient with an acute eye problem begins with documentation of the level of vision in each eye, except in the case of a splash injury. In such cases, immediate copious irrigation is of critical importance. Subconjunctival hemorrhage is common and, typically, completely benign. Herpes simplex infection is painful and can lead to extensive damage. Herpes zoster infection is usually accompanied by skin lesions and can be effectively treated with oral acyclovir or famcyclovir. In patients with Bell's palsy, the eye must be carefully protected to prevent secondary injury. Corneal abrasions heal rapidly when antibiotics and patch protection are provided. Acute infections of the eyelids and conjunctivae usually respond well to topical antibiotics and warm compresses. Traumatic injuries require careful evaluation and, frequently, referral to an ophthalmologist.