Approach by symptom

Red eye, sudden, progressive or transient visual loss, eye pain, diplopia, leukocoria, floaters and flashes, anisocoria and more.

14 pages

• Anisocoria: which pupil is abnormalUnequal pupils are often normal
• Double vision: monocular or binocularCover one eye
• Drooping eyelid (ptosis)Most drooping lids in older adults are a stretched tendon
• Eye pain and painful visual lossEye pain with reduced vision is almost always serious
• Floaters and flashesNew floaters and flashes are usually the vitreous gel peeling off the retina
• Gradual visual loss in adultsVision fading over months is usually glasses, cataract, glaucoma or macular degeneration
• Leukocoria: the white pupilA white pupil in a child, in the exam or in a flash photo, can be a retinal cancer
• Localising a visual field defectThe shape of a field defect shows the lesion: one eye is the eye or optic nerve, both temples…
• Proptosis and periorbital swellingA bulging eye in an adult is usually thyroid disease; in a child with fever, orbital infection
• Red eye: what is serious and what is notMost red eyes are conjunctivitis or a small bleed and settle alone
• Sudden painless visual lossVision lost in minutes or hours without pain is an emergency: the retina, optic nerve or brain…
• The swollen optic disc: papilloedema or notTwo swollen optic discs mean raised pressure in the skull until imaging says otherwise
• The watering eye (epiphora)A watery eye makes too many tears or drains them poorly
• Transient visual loss (amaurosis fugax)Vision that goes dark in one eye for minutes and comes back is a warning stroke of the eye

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← Ophthalmology for the general doctor

Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once.

Representative model, for educational purposes only.