OPHTHALMIC EMERGENCY SITUATIONS

Symptoms related to a medical emergency revolve around 3 axes: a red eye, a decrease in visual acuity and eye pain.
Ocular trauma (shock, perforation, chemical spraying) is also a reason for consultation in ophthalmic emergency departments.

Red eye associated with pain and / or visual acuity is an emergency situation. It is therefore necessary to separate the real pain from a sensation of sand or burns.

The red eye without pain and without sharpnessis impressive but usually not serious in adults. A straight red in a flat and homogeneous. Often caused by capillary fragility associated with violent exertion (constipation, childbirth, violent coughing) resulting in increased venous pressure. Subconjunctival haemorrhage may also be due to vascular disorders, so it is advisable to talk to your GP.

The sore and purulent red eye, is an ophthalmological emergency.The redness is diffuse with sensation of sand. Conjunctivitis can be bacterial (purulent and abundant secretions) or viral (low secretions, itching and high risk of contagion). A slight decrease in visual acuity and / or light discomfort are considered to be factors of increased severity. The allergic conjunctivitis (strong itching, weak secretions) of sudden onset and often chronic or seasonal is rather minor.

The painful red eye with a decrease in visual acuity, is an extreme ophthalmological emergency. The redness is intense and more marked around the cornea which can also lose its transparency. The eye may have abnormal hardness and the pupil may be blocked in the dilated position. The glaucoma crisis can lead to a decrease of visual acuity, a strong eye pain, important headaches. The pain is less marked than in the case of glaucoma and the pupil can be contracted. Uveitis can cause a decrease in visual acuity.

Sand sensation with a slight decrease in visual acuity, ophthalmic emergency. The pain is localized on the eye (sensation of foreign body). Keratitis may cause a slight decrease in visual acuity and / or increased sensitivity to light.

Decreased visual acuity and / or visual field, ophthalmic emergency. A sudden decrease in visual acuity, a decrease in the visual field, the appearance of flashes, the vision of a fixed black spot or a distorted vision may be grounds for consultation in ophthalmic emergencies.

Decrease in transient visual acuity or headaches. These symptoms when isolated are rarely grounds for emergency consultation. A decrease in transient visual acuity or headaches may require wearing glasses. What to do in an ophthalmic emergency

THE GOLDEN RULES: 

Never take treatment without medical advice.
Immediately stop wearing lenses in case of conjunctivitis or keratitis.
Rinse thoroughly with chemical sprays and go to the nearest ophthalmic emergency department immediately.
If there is a sudden drop in visual acuity or visual field, glaucoma or uveitis, you should go to the nearest ophthalmic emergency department immediately.
Less urgent, the other signs of call also require consultation in emergency.

It is better to be told "All is good" rather than "Why did not you come earlier?
Do not overload emergencies unnecessarily.
Lose your contact lenses or have your glasses broken, even if it's very disabling it is not a medical emergency!

WHERE TO GO IN CASES OF OPHTHALMOLOGICAL EMERGENCY:

Mornings of working days, you can turn to the ophthalmology consultations and services of the following AP-HP hospitals:

Ambroise Paré, Avicenne, Bicêtre, Bichât, Claude Bernard, Beaujon, Cochin, Louis Mourier, Lariboisière (also in the afternoon from 1:30 pm to 5:30 pm) Pitié-Salpêtrière, Saint-Antoine, Saint-Louis, Tenon, every day (morning and afternoon, except Wednesday and Friday afternoons).

Afternoons, nights, Sundays and holidays, go to:

Centre Hospitalier National d’Ophtalmologie 28, rue de Charenton 75012 PARIS
Phone: 01.40.02.15.20

For kids, you can turn to the ophthalmology consultations and services of the following AP-HP hospitals:

Necker-Enfants Malades, Robert Debré , Armand Trousseau and Saint-Vincent de Paul.

 

 

DIABETIC RETINOPATHY: Simple, fast and pain-free screening.   

Diabetes affects 347 million people worldwide. This chronic disease can damage the heart, blood vessels, eyes, kidneys and nerves. Diabetic retinopathy can lead to blindness as it develops, including diabetes-related complications in the eyes.

WHAT IS DIABETIC RETINOPATHY?  

The word "retinopathy" means that the disease affects the retina, that is, the area at the back of the eye that allows us to see; and the word "diabetic", that this disease is due to diabetes.   

WHO IS CONCERNED ?  

Diabetic retinopathy affects 40% of diabetics (type 1 and 2). It is the first cause of non-clairvoyance among the under 50s. In France, there are 1000 cases of total ocular blindness each year due to diabetic retinopathy not detected in time.  

HOW DOES THE DISEASE DEVELOP?  

The excess sugar in the blood caused by diabetes has the effect of gradually damaging our arteries and veins. Fragile, the blood vessels of the retina break, creating small bleeding. In the beginning, the attacks are peripheral and often invisible without a specific examination. If the disease is allowed to spread, it will eventually touch the center of the retina, creating severe and irreversible vision problems.   

To know: Even without symptoms (blurred or fluctuating vision, deformed letters, difficulty passing from light to darkness), the disease is present and evolves silently. It is therefore advisable to act before the decline in vision and the appearance of irreversible complications.  

Certain periods of life (puberty, pregnancy, cataract surgery or heart failure or kidney failure) may increase the risk of complications of the disease. They therefore require increased vigilance.

HOW TO TREAT IT?  

Some treatments (notably the laser) exist to slow the evolution of the disease and avoid blindness but they do not currently allow to find a clear vision because the attacks are irreversible.  

Strict control of diabetes and high blood pressure are essential but not always enough to guard against diabetic retinopathy, the best treatment is through prevention.  

PREVENTION FIRST!  

Most often, screening for the disease is done through the following tests: the measurement of visual acuity accompanied by the essential examination of the fundus allowing the early detection of the disease.

The examination of fundus is performed by the instillation of eye drops for pupillary dilation, this practice exposes to certain risks. In addition driving a vehicle is not recommended for several hours after the examination.  

But more recently, the non-mydriatic retinograph appeared. Less restrictive, it allows a digital photography in high definition of the fundus without dilation of the pupil. Accurate, fast and safe, this examination, recognized and approved in France by the Haute Autorité de Santé, is conducted by professionals in the visual health sector in specialized vision centers such as Ophtacity.

DIABETICS, PRESERVE YOUR VISION

Annual screening
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Balance of blood sugar and blood pressure
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Preserve your health capital (regular practice of physical activity and good nutrition)
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Vision preserved.

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