Emergencies

These emergencies require immediate presentation to the ophthalmologist / clinic:

(a) Giant cell arteritis (arteritis temporalis)

Symptoms:
Headache in the temporal region, pain when chewing or combing hair, worsening of vision, (joint discomfort).

Clinical signs:
Temporal arteries painfully thickened with weak pulse.

Who is affected?
Predominantly women over the age of 50.

Giant cell arteritis, if left untreated, can lead to irreversible loss of vision in both eyes within a very short time. It is considered an ophthalmologic emergency and must be examined / treated immediately (at the weekend / after hours in a clinic). Every minute counts.


b) Stroke in the eye / brain

Transient ischemic attack, occlusion of the central artery / brain-supplying arteries, anterior ischemic optic neuropathy (AION)

Symptoms:
Minute-long to permanent acute onset of massive visual deterioration, often noticed early in the morning after waking, sometimes accompanied by speech disturbance, double vision, visual field loss, sensory deficit, or diminishing strength.

Who is affected?
Women / men of advanced age, with previous damage to vessels of the heart or neck, cardiac arrhythmias.

Stroke of the eye / brain is an emergency that requires immediate assessment in a clinic (stroke-unit of a neurological department). Within an interval of 6 hours after vessel occlusion there is still a chance of vessel re-opening; time is running.


c) Fragmentation of the brain-supplying artery
= dissection of the internal carotid artery and its branches

Symptoms:
Stabbing headache, combined with acute drooping eyelid, pupil of affected eye smaller in dark surrounding, hyperthermia of the facial half of the affected side.

Who is affected?
Genetically predisposed patients, pat with crush injuries in the area of the neck (safety belt. Sports).

Similar symptoms are also known in (disseminated) inflammations / space-occupying lesions in the region of the skull base and the sinuses.

These symptoms require urgent clarification with imaging (MRI / CT) in a clinic.

After diagnosing the cause, the patient can be treated medically-pharmacologically, less frequently invasively-surgically.


e) Inflammation

Symptoms:
Within a short time (hours to a few days) increasing visual deterioration, redness, pain, photophobia, glare sensitivity.

Who is affected?
Women, men, children, all ages including newborns.

Possible causes:

Previous eye surgery in the past four weeks.
Pathogens that have entered the eye from the outside such as foreign bodies, bacteria, viruses, chlamydia, fungi
Pathogens coming from inside (after intestinal surgery, sepsis (of the urinary tract, heart valves), immune deficiency (herpes, zoster).

The more dramatic the course, the more urgent the need for examination.


f) Sudden increase in eye pressure.

Symptoms:
Seeing colored rings around light sources, especially in the evening, blurred vision, cannot be improved by blinking, eye massively reddened, pupil clearly dilated in side comparison, in side comparison the affected eye is rock hard (palpation of the eye with closed lid), nausea and vomiting.

Who is affected?
Women and men of advanced age, often severely farsighted in spectacle correction (plus lenses that make the eyes appear larger).

With timely diagnosis and treatment (eye drops, tablets, laser of the iris), permanent deterioration can be mitigated.

In case of inaccessibility of the doctor or increasing pain / acute or increasing visual deterioration after recent eye surgery:

Notfalllpraxen der KV Hamburg:
Stresemannstr. 54
22769 Hamburg

Berner Heerweg 124
22159 Hamburg

Opening hours:
Monday, Tuesday, Thursday, Friday 19 – 24 Uhr
Wednesday 13 – 24 Uhr
Saturday, Sunday, Holidays 7 – 24 Uhr

Hospitals with 24-hour staffed eye department:
UKE Universitätsklinikum Eppendorf
Martinistr. 52
20246 Hamburg
Tel: 040 – 7410-0

Asklepios-Klinik Nord Heidberg
Tangstedter Landstr. 400
22417 Hamburg
Tel: 040 – 181887-0