Red Eye - Optometrist, Walk-In Clinic, or Emergency Room?

Common questions

Should I go to a walk-in clinic or an optometrist for a red eye?

An optometry office is an appropriate first stop. We examine the eye at a slit lamp - a microscope built for the eye - which shows the cornea and the structures behind it directly. That matters because a corneal ulcer or iritis can look like ordinary pink eye but need a different response; if it really is pink eye, we can tell you that too. Go straight to an emergency department instead for sudden vision loss, a chemical splash, a significant eye injury, or severe pain with nausea, vomiting, or haloes around lights.

When is a red eye an emergency?

Most red eyes are not emergencies. Call the same day if you have pain rather than mild irritation, light sensitivity, blurred or reduced vision, or you wear contact lenses. Go to an emergency department instead for a chemical splash, a significant eye injury, sudden vision loss, or severe pain with nausea, vomiting, or haloes around lights - that combination can mean a sudden rise in eye pressure, treated in hours, not days, because sustained high pressure damages the optic nerve permanently.

How do I know if it is pink eye or something more serious?

Pink eye usually means itching, a gritty feeling, discharge, and both eyes affected, without much pain or light sensitivity. Something more serious usually means pain rather than irritation, light sensitivity, blurred or reduced vision, and only one eye affected. If you wear contact lenses, treat it as more serious regardless of which symptoms you have. These are things to notice, not a diagnosis you can make yourself - a slit lamp exam is the only reliable way to tell them apart.

Why does a red eye matter more if I wear contact lenses?

A contact lens sits directly on the cornea, so a red or painful eye in a contact lens wearer carries a specific risk: a corneal ulcer, an infection of the cornea that can threaten vision if not caught early. That is why we treat a red, painful eye in a contact lens wearer as more urgent, and why it moves you up the list when you call. Mention your contact lens wear even if you already took the lenses out - it changes how quickly you need to be seen.

Is pink eye contagious, and can I go to work?

Viral and bacterial pink eye are both contagious, mainly through contact with eye discharge and then touching your face or shared surfaces. Allergic pink eye, from pollen or pet dander, is not contagious. Since you cannot reliably tell these apart yourself, the safer approach with a new red, weepy, or discharging eye is to avoid sharing towels or pillows, wash your hands often, and check with us or your workplace before returning, especially around young children or anyone with a weakened immune system. An exam can tell you which type you have.

What is iritis?

Iritis (anterior uveitis) is inflammation inside the eye, affecting the iris and nearby structures, rather than on the surface. It typically causes a deep ache rather than surface irritation, marked light sensitivity, and sometimes blurred vision, often in one eye. It is not contagious, and you cannot identify it by looking at the eye - diagnosing it needs a slit lamp exam that looks inside the front chamber of the eye. It needs to be seen promptly, because untreated inflammation inside the eye can affect vision.

What will an optometrist do for a red eye?

We ask what you are feeling, how long it has been going on, and whether you wear contact lenses. Then we examine the eye at the slit lamp, sometimes using a drop of dye called fluorescein to highlight any damage. That tells us what is happening and lets us treat what is treatable in the office. If you need a specialist, we refer you directly to ophthalmology and send our findings along. Before the eye has been looked at, do not use leftover prescription drops - steroid drops especially can make an undiagnosed infection worse.

Related

• Urgent eye problems - optometrist vs ER - when to call, when to go to emergency
• Do I need an appointment? - how walk-ins and urgent problems are handled
• Allergy eye drops in Canada - what is available for itchy, allergic eyes
• Floaters and flashes - when to worry - a different urgent symptom and when it needs same-day care