8 signs you need to see your eye doctor

While eye doctors recommend a yearly eye exam for those 40 and older (even if you have no vision issues), Dr. Laura Sanders, an ophthalmologist affiliated with Advocate Illinois Masonic Medical Center in Chicago, says if you notice any of the following symptoms, you should get to your eye doctor as soon as possible, or the ER at once.

1. Sudden loss of vision in one or both eyes:
   • Brief, temporary or long-lasting, this can be a sign of a stroke, retinal detachment or a bleed into the back of the eye from uncontrolled diabetes or hypertension. If you have other symptoms of a stroke, call 911.
   • In elderly patients, this symptom is particularly concerning when associated with jaw pain, headache, weight loss or illness, as it may be caused by Giant Cell Arteritis, an inflammatory disease affecting the large blood vessels of the scalp, neck and arms, requiring treatment with steroids. When left untreated, it may result in permanent loss of vision in one or both eyes.

2. Sudden onset of double vision:
   • This may be a result of diabetes or hypertension affecting the muscles controlling the eye.
   • Hyperthyroidism (an overactive thyroid gland), the most common being Graves’ disease, can also alter the size and shape of the eye muscles and can lead to the eyes appearing more prominent, the lids retracting and the surface of the cornea changing.
   • The presence of double vision and a sudden eyelid droop with a change in the pupil size could be associated with an aneurysm, which if left untreated, could pose serious harm. Call 911 if you notice this.
   • When associated with trauma, double vision could suggest a fracture of the orbit.

3. New onset of or change in floaters (spots in your vision):
   • This could be a sign of retinal tear or detachment.

4. Severe eye pain, redness, dilation of the pupil:
   • This could be a sign of acute angle-closure glaucoma, caused by rapid or sudden increase in the pressure within the eye. This is a condition more common in middle-aged and elderly patients, with a higher onset in Asians or those who are far-sighted.
   • Vision problems that surface as glare in the daytime or halos, bright circles that show up around a light source, when you are in a dim or a dark place, may indicate the need for an urgent laser treatment to provide outflow for fluid in the eye.

5. Change around the eyes:
   • Bleeding, growth and change in color of spots and lesions, as well as loss of eyelashes, could all be signs of cancer.

6. Sudden facial droop with an inability to close an eye:
   • This facial palsy could be a sign of a stroke. If it’s accompanied by change of speech and body weakness, call 911. If the eye does not close after emergent treatment for stroke, this should be promptly evaluated to avoid permanent damage to the surface of the eye (the cornea).

7. Sudden eye pain, redness, tearing, light sensitivity in a contact lens wearer
   • Immediate evaluation is needed to rule out a corneal ulcer, an open sore that forms on the front of the eye.

8. Chemical injury:
   • If you splash acid or bleach into your eye, rinse your eye out with eye wash or water AND seek immediate attention in an emergency room.

The following eye symptoms do not require an emergent exam, but Dr. Sanders says they should be discussed with your doctor.

• Red eyes that are itchy and swollen, with or without mucus discharge, usually indicate that a patient is suffering from allergies, either seasonal or from an allergic reaction. This can typically be treated with over-the-counter eye drops, but use the ones labeled “natural tears”. If your red eyes do not clear up, it’s time to see a doctor.
• Redness when associated with light sensitivity and floaters (spots in your vision) may be from an inflammatory condition called iritis and sometimes occurs after infections or may be related to arthritic conditions.
• Itching is typically a symptom of allergies and responds to antihistamines and cool compresses.
• Excessive tearing can be caused by a blockage in the drainage system of the eye or reflexive tearing from inflammatory conditions including dry eye.
• Intermittent blurred vision, which clears with blinking, is often associated with dry eyes or corneal surface issues and is usually managed with regular use of artificial tears.
• Burning or having the sensation that something is in your eye is often associated with dry eye conditions or inflammation of the eyelid oil glands called the meibomian glands.
• Difficulty seeing or focusing clearly on close objects, a condition called presbyopia, can occur as the lens of the eye loses accommodative powers in middle age. This may require reading glasses. Presbyopia can also be caused by certain medications, like antidepressants, antihistamines and diuretics, so be sure to discuss all medications you take with your eye doctor.