When to Call Your Eye Doctor vs Go to the ER

Eye problems can be hard to judge.

Some symptoms are uncomfortable but not dangerous. Some look mild at first but need urgent care. Some can be handled by your eye doctor the same day. Others belong in the emergency room.

This is where families often feel stuck.

• A child wakes up with a red eye.
• A contact lens wearer has pain.
• An adult suddenly sees flashes and floaters.
• Someone gets sunscreen, cleaning spray, or pool chemicals in the eye.
• A teen gets hit in the eye during sports.

Do you call the eye doctor? The pediatrician? Urgent care? The ER?

The answer depends on the symptoms.

As a general rule, sudden vision loss, severe eye pain, chemical exposure, major injury, new flashes or floaters with vision changes, and a red eye with light sensitivity or decreased vision should be treated urgently.

If you are unsure, call. It is better to ask early than wait on an eye problem that could get worse.

Why the Eye Doctor Is Often the Right First Call

Many people assume the ER is always the best place for an eye problem.

Sometimes it is.

But many eye problems are best evaluated by an eye doctor because the eye doctor has the equipment needed to look closely at the cornea, retina, optic nerve, eye pressure, prescription, contact lens fit, and eye surface.

A medical eye visit can often evaluate:

• Red eyes
• Pink eye
• Allergies
• Dry eye
• Eye pain
• Light sensitivity
• Contact lens irritation
• Styes
• Scratches on the eye
• Foreign body sensation
• New blurry vision
• Flashes and floaters
• Eye injuries
• Sudden prescription changes
• Headaches related to vision

The ER is important when symptoms suggest a serious injury, neurologic emergency, chemical burn, severe infection, or condition that needs hospital-level care.

The eye doctor is important when the problem needs a detailed eye exam and treatment plan.

When to Go to the ER or Seek Emergency Care

Go to the ER or seek emergency medical care right away if you have:

• Sudden vision loss
• A curtain, shadow, or dark area in your vision
• Severe eye pain
• Eye pain with nausea or vomiting
• A chemical splash in the eye
• A puncture injury to the eye
• A large cut on or around the eye
• One pupil suddenly larger than the other
• New weakness, facial drooping, confusion, or trouble speaking with vision changes
• Vision changes after head trauma
• A severe headache with vision changes
• A red eye with severe pain, light sensitivity, or decreased vision
• Major swelling around the eye after injury
• Trouble moving the eye after trauma
• Blood or pus coming from the eye after injury
• A child who cannot open the eye after injury or chemical exposure

These symptoms should not wait for a routine appointment.

If symptoms are severe, rapidly worsening, or connected to a possible stroke, head injury, chemical exposure, or major trauma, call emergency services or go to the ER.

When to Call the Eye Doctor the Same Day

Call the eye doctor the same day if you have:

• New eye pain
• Redness with light sensitivity
• Redness with blurry vision
• A contact lens-related red eye
• A scratchy feeling that does not go away
• Something stuck in the eye
• New flashes of light
• New floaters
• A sudden increase in floaters
• A shadow or missing area in vision
• Eye injury
• A child with eye swelling or discharge
• Thick yellow or green discharge
• A painful stye or eyelid swelling
• Blurry vision that started suddenly
• Double vision
• Eye symptoms after concussion
• Symptoms that are getting worse instead of better

Many of these symptoms may still need urgent care, but your eye doctor can help direct you.

If the office is closed and symptoms are severe, go to the ER.

When It May Be Okay to Schedule a Routine Visit

Some symptoms can usually be scheduled as a regular eye exam, unless they are severe, sudden, or worsening.

These may include:

• Gradual blurry vision
• Needing to update glasses
• Mild dry eye symptoms
• Mild allergy symptoms
• Eye strain after screens
• Trouble reading small print
• Mild headaches with near work
• Routine contact lens discomfort without redness or pain
• Annual eye exam
• A child who may need glasses
• Squinting
• Trouble seeing the board
• Mild light sensitivity that is not sudden
• Watery eyes that come and go

Even routine symptoms deserve attention if they keep happening.

But they are different from sudden vision loss, severe pain, trauma, or chemical injury.

Chemical in the Eye

A chemical splash in the eye is an emergency.

This includes cleaning products, bleach, pool chemicals, drain cleaner, oven cleaner, fertilizer, pesticides, battery acid, strong soaps, or any unknown chemical.

Do not wait to call first.

Start rinsing the eye immediately with clean running water or saline. Keep rinsing while someone else calls for help if possible.

If contact lenses are in the eye, begin rinsing right away. The lens may come out during rinsing.

• Do not try to neutralize the chemical with another chemical.
• Do not rub the eye.
• Do not wait to see if it feels better.

After rinsing, seek emergency medical care or urgent eye care.

Chemical injuries can damage the surface of the eye quickly, especially alkaline chemicals such as some cleaners, drain products, and cement-related materials.

Something Stuck in the Eye

If something feels stuck in the eye, first avoid rubbing.

Rubbing can scratch the cornea.

If it is a small loose particle like dust or an eyelash, gentle flushing with clean water or saline may help.

Call the eye doctor if:

• The feeling does not go away
• There is pain
• The eye is red
• Vision is blurry
• Light hurts
• You were grinding metal, doing yard work, or exposed to flying debris
• You wear contact lenses
• You think something may be embedded in the eye

Do not try to remove an object that appears stuck in the eye.

If there is a puncture injury or object embedded in the eye, seek emergency care.

Eye Injury

Eye injuries should be taken seriously, especially in children and athletes.

Call the eye doctor or seek emergency care after:

• A ball hits the eye
• A finger pokes the eye
• A branch or plant scratches the eye
• A toy hits the eye
• A chemical gets in the eye
• Glasses break near the eye
• A child falls and hits the eye area
• A foreign object gets in the eye
• There is swelling, bruising, pain, or vision change

Go to the ER if the injury is severe, there is bleeding, the eye looks misshapen, vision is reduced, the child cannot open the eye, or there may be a puncture wound.

• Do not press on the eye.
• Do not let your child rub the eye.
• Do not patch the eye tightly unless directed by a medical professional.

If possible, protect the eye without applying pressure and seek care.

Red Eye

A red eye can be simple, but it can also be serious.

Call the eye doctor if the red eye comes with:

• Pain
• Light sensitivity
• Blurry vision
• Contact lens wear
• Thick discharge
• Swelling
• Injury
• Chemical exposure
• A white spot on the eye
• Symptoms in a baby
• Symptoms that are getting worse
• Symptoms that do not improve as expected

A mild itchy red eye may be allergies.

A watery red eye may be viral pink eye.

A red eye with discharge may be bacterial conjunctivitis.

A red painful eye with light sensitivity or decreased vision needs medical care.

Do not assume every red eye is pink eye.

Pink Eye

Pink eye is common, especially in children.

But not every red eye is pink eye, and not every case needs antibiotic drops.

Call the eye doctor if:

• The eye is painful
• Light hurts
• Vision is blurry
• The child wears contact lenses
• There is significant swelling
• There is thick discharge
• Symptoms keep returning
• The child is very young
• The eye does not improve
• The school requires clearance

If symptoms are mild and seem allergy-related, a routine or same-day medical eye visit may still help, especially if the child is uncomfortable or rubbing constantly.

Contact Lens Problems

Contact lens wearers need to be more careful.

A red eye in a contact lens wearer is not something to ignore.

Remove the contact lenses and call the eye doctor the same day if you have:

• Redness
• Pain
• Light sensitivity
• Blurry vision
• Discharge
• A white spot on the eye
• A feeling that something is stuck
• Symptoms that started while wearing lenses
• Symptoms after sleeping in contacts
• Symptoms after swimming or showering in contacts

Do not put the lenses back in until the eye doctor says it is safe.

Contact lens-related infections can become serious.

Flashes and Floaters

New flashes or floaters should be taken seriously, especially if they start suddenly.

• Floaters can look like spots, strings, cobwebs, bugs, or shadows drifting through vision.
• Flashes may look like lightning streaks, sparks, or brief flickers of light.

Call the eye doctor right away if you notice:

• New floaters
• A sudden increase in floaters
• Flashes of light
• A curtain or shadow in your vision
• Missing side vision
• Vision loss
• Symptoms after eye trauma

These symptoms can sometimes be related to the retina.

A retinal tear or detachment needs urgent evaluation.

If you have a curtain, shadow, or sudden vision loss, seek emergency care.

Sudden Blurry Vision

Sudden blurry vision should be evaluated quickly.

It can come from many causes, including dry eye, corneal problems, inflammation, retinal problems, optic nerve problems, blood sugar changes, migraine, stroke, or other medical issues.

Call the eye doctor right away if blurry vision comes on suddenly, affects one eye more than the other, or is associated with pain, redness, light sensitivity, double vision, headache, weakness, numbness, speech problems, or dizziness.

If blurry vision is connected with neurologic symptoms, go to the ER.

Double Vision

Double vision should be checked.

If double vision is new, sudden, constant, or associated with headache, weakness, dizziness, drooping eyelid, pupil changes, trouble speaking, or trouble walking, seek urgent medical care.

Double vision can come from eye alignment problems, nerve problems, muscle problems, trauma, concussion, or medical conditions.

In children, double vision may show up as closing one eye, head tilting, headaches, avoiding reading, or saying words look funny.

Do not ignore new double vision.

Eye Pain

Eye pain is a symptom that deserves attention.

Mild irritation may be dryness, allergy, or a small scratch.

But severe pain, pain with light sensitivity, pain with nausea or vomiting, pain after injury, pain with a red eye, or pain with vision changes should be evaluated urgently.

Call the eye doctor same day or seek emergency care depending on severity.

If the pain is severe or vision changes suddenly, do not wait.

Headache with Eye Symptoms

Headaches can have many causes.

Vision can be one piece, especially when headaches happen with reading, screens, schoolwork, or focusing.

But some headache patterns need urgent medical care.

Go to the ER or seek urgent medical care if headache is sudden and severe, associated with vision loss, confusion, weakness, fever, vomiting, unequal pupils, head injury, stiff neck, or neurologic symptoms.

Call the eye doctor if headaches are connected to reading, screen use, blurry vision, double vision, eye strain, or trouble focusing.

Children and Eye Emergencies

Children often cannot explain eye symptoms clearly.

A child may not say, “My vision is blurry.”

They may say:

“My eye hurts.”

“My head hurts.”

“I cannot open my eye.”

“The light hurts.”

“There is something in my eye.”

“I do not want to read.”

Parents should pay attention if the child is squinting, covering one eye, rubbing one eye constantly, avoiding light, tearing, blinking a lot, or acting very uncomfortable.

Call the eye doctor promptly if your child has eye pain, injury, redness with light sensitivity, swelling, discharge, blurry vision, or cannot keep the eye open.

Go to the ER for severe injury, chemical exposure, sudden vision loss, severe pain, or concerning neurologic symptoms.

Babies and Red Eyes

Red eyes in babies should be handled carefully.

Call promptly if a baby has:

• Significant redness
• Swelling
• Discharge
• Constant tearing
• Light sensitivity
• Cloudy looking eye
• A white pupil reflex in photos
• The eye does not open normally
• The baby seems uncomfortable
• Any injury or chemical exposure

Babies cannot describe symptoms, so it is better to check early.

What Not to Do

When eye symptoms are concerning, avoid these common mistakes:

• Do not use old antibiotic drops
• Do not share eye drops between family members
• Do not keep wearing contacts with a red or painful eye
• Do not rub an injured eye
• Do not press on the eye after trauma
• Do not try to remove an embedded object
• Do not patch the eye tightly after injury unless directed
• Do not wait on sudden vision loss
• Do not assume pain is normal
• Do not ignore flashes, floaters, or a curtain in vision
• Do not use redness reliever drops to mask a serious red eye
• Do not wait to rinse after chemical exposure

The wrong first step can delay the right treatment.

Should You Call the Pediatrician?

Sometimes.

Your child’s pediatrician is important for fever, illness, head injury, neurologic symptoms, infection concerns, and overall medical care.

But for many eye-specific symptoms, the eye doctor is the better first call because they can examine the eye directly.

• Call the pediatrician or seek urgent medical care if your child has fever, swelling around the eye, severe illness, trauma, neurologic symptoms, or concern for an infection spreading beyond the eye.
• Call the eye doctor for red eye, pain, discharge, blurry vision, light sensitivity, contact lens problems, possible scratches, or vision changes.

If you are unsure, calling either office is better than waiting.

What Can the Eye Doctor Do During a Medical Eye Visit?

A medical eye visit may include:

• Checking vision
• Looking at the eye under magnification
• Checking for scratches
• Checking for infection or inflammation
• Measuring eye pressure when needed
• Looking for foreign bodies
• Checking the eyelids
• Evaluating contact lens-related problems
• Dilating the eyes if flashes or floaters are present
• Looking at the retina
• Prescribing medication when appropriate
• Referring to a specialist or ER when needed

The eye doctor can help decide whether the problem can be treated in-office or needs a higher level of care.

A Simple Way to Decide

Use this guide.

Go to the ER or seek emergency care for:

• Sudden vision loss
• Severe eye pain
• Chemical exposure
• Puncture injury
• Major trauma
• Eye symptoms with stroke-like symptoms
• A curtain or shadow in vision
• Red eye with severe pain or sudden vision change
• Eye pain with nausea or vomiting
• Inability to open the eye after injury

Call the eye doctor the same day for:

• Red eye with discomfort
• Light sensitivity
• Contact lens related symptoms
• New flashes or floaters
• Eye injury that seems mild but still hurts
• Foreign body sensation
• Blurry vision that started suddenly
• Double vision
• Discharge
• Symptoms that are worsening

Schedule a routine eye visit for:

• Gradual blur
• Glasses updates
• Mild dry eye
• Mild allergies
• Screen strain
• Routine contact lens care
• Squinting
• Reading or school-related visual symptoms
• Annual exam
• Preventive care

If your symptoms fall between categories, call.

Medical Eye Care at Pediatric & Family Vision

At Pediatric & Family Vision, we see children, teens, and adults for primary eye care and medical eye concerns.

That includes red eyes, pink eye, allergies, dry eye, eye pain, contact lens irritation, blurry vision, flashes, floaters, eye injuries, and vision symptoms after concussion.

If your symptoms are appropriate for an office-based medical eye visit, we can examine the eye and guide treatment.

If your symptoms need emergency care, we will tell you that clearly.

The most important thing is not to ignore eye symptoms that are sudden, painful, or affecting vision.

If you are not sure whether to call the eye doctor or go to the ER, call for guidance. If vision changes suddenly, pain is severe, a chemical got in the eye, or there are neurologic symptoms, seek emergency care right away.