The­se emer­gen­ci­es requi­re immedia­te pre­sen­ta­ti­on to the oph­thal­mo­lo­gist / clinic:

(a) Giant cell arteritis (arteritis temporalis)

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)

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?
Men / women 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

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, pati­ents 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.


d) Acute double vision

Acu­te dou­ble visi­on occurs only when see­ing with both eyes at the same time.
The two impres­si­ons are posi­tio­ned asi­de, abo­ve or obli­que­ly / skew (asi­de and abo­ve at the same time) of each other. The distance bet­ween the­se impres­si­ons depends on (the neck / head kept sta­ble) the direc­tion in which your eyes are loo­king. To avoid the­se dif­fe­rent impres­si­ons, some­ti­mes the head is til­ted or turned.
Dou­ble (defo­cu­sed) impres­si­ons when see­ing with one eye only are due to opa­ci­ties in the cor­nea, the lens, the vit­re­ous, the (cen­tral) reti­na, the tear­film or refrac­ti­ve errors like astigmatism.

Who is affected?
Men and women of all age groups. The dou­ble visi­on can be cau­sed by trau­ma, inflamma­ti­on, redu­ced blood per­fu­si­on or space-occu­p­y­ing lesi­ons of the brain.

Immedia­te exami­na­ti­on (MRI) is necessa­ry, espe­cial­ly when the sym­ptoms are accom­pa­nied by vomi­t­ing, hea­da­che, fati­gue, redu­ced strength or numb­ness, redu­ced visi­on or visu­al field defects (e.g. you can­not see clear­ly to one side / cen­tral­ly with both eyes).

e) Inflammation

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

Who is affected?
Men, women, 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.

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?
Men and women 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

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