Urgent Eye Problems: Call Optometrist vs ER

Call us for any of this

These all need to be examined rather than answered over the phone. Call 416-703-2797 and we will find you a time.

Sudden changes in vision

• any sudden loss of vision, in one eye or both
• a new curtain or shadow moving across your vision
• new flashes of light, or a sudden increase in floaters
• sudden onset of double vision

A painful or red eye

• severe eye pain, with or without nausea, and haloes or rainbow rings around lights
• a red eye with pain, light sensitivity, or blurred vision
• contact lens pain, or an infection related to lens wear
• shingles around the eye, and cold sore infections affecting the eye
• welder’s flash and other ultraviolet burns

Injuries to the surface, and swelling

• corneal scratches and abrasions
• something on the surface of the eye, or grit that will not settle
• a swollen eyelid, whatever it looks like — styes, chalazia, and spreading swelling
• blood across the white of the eye
• conjunctivitis — bacterial, viral, or allergic
• a sudden dry eye flare that will not settle

You are seen and treated by an optometrist here. We examine the eye with a slit lamp, measure the pressure inside it, and dilate and examine the retina. OCT and retinal photography are part of how we work up an urgent problem.

Go to an emergency department instead if

• vision loss came on with weakness, slurred speech, or a facial droop — call 911
• the eye was struck with force — a ball, an elbow, a fall, a tool
• anything may have penetrated the eye, or a fragment came off grinding, hammering, or drilling
• there has been a chemical splash — flush first, see below
• we are closed

One timing exception. We can arrange urgent specialist care during the week. After midday on a Friday that is often no longer possible before the weekend, so if you lose vision suddenly on a Friday afternoon, start at an emergency department.

If you are unsure, err on the side of safety.

Chemical splash: flush first, phone second

Start flushing immediately with clean water or saline, and keep going for at least 15 minutes. Do this before you call anyone — the first few minutes matter more than the phone call does. Hold your eyelids open and let the water run across the eye from the inner corner outward.

Then go to the nearest emergency department. Bring the container or the product name if you can grab it on the way.

Something stuck in your eye

Do not rub it. Rubbing is what turns a surface scratch into a real injury.

Do not try to remove anything embedded in the eye itself. If an object is stuck in the eye or the eye may have been penetrated, don’t press on it and don’t try to pull it out — cover the eye without putting any pressure on it and go to an emergency department.

For a loose eyelash, a speck of dust or metal, grit under the lid, or a gritty feeling that will not settle, call us. Surface foreign bodies come out in the office.

About a curtain or shadow

A curtain or shadow can mean a retinal tear or detachment, and it does need to be looked at the same day. Call us first while we are open: we can dilate, examine the retina, and refer you directly to a retinal specialist. If we are closed, go to an emergency department rather than waiting for us to open.

Wearing contacts? Say so when you call

If your eye is red or painful and you wear contact lenses, tell us that first. A red painful eye in a contact lens wearer is treated as a different problem than the same eye in someone who doesn’t wear lenses — it moves you up the list. Mention it even if you think it’s unrelated, and mention it even if you’d taken the lenses out before the symptoms started.

What to have ready when you call

• what you are feeling — pain, vision change, redness, light sensitivity
• which eye, or both
• when it started, and whether it is getting worse
• whether you were wearing contact lenses when it started
• any injury, chemical, or foreign material involved

Can you see me today?

Sometimes, depending on the day. We would rather be honest than promise a slot we don’t have.

Call or text the office rather than showing up — staff can see the whole schedule, including openings that come up from cancellations, and they will make room where they can. If we cannot see you fast enough for what you are describing, we will say so and tell you where to go instead.

After hours, weekends, and holidays

We are open Monday to Friday, 9:00am to 5:00pm, and we do not offer after-hours or weekend service. Our holiday hours are posted at the bottom of every page.

If something sight-threatening happens outside our hours, go to the nearest hospital emergency department — don’t wait for us to open.

If you’re not sure whether what you’re experiencing needs urgent care, Health811 (formerly Telehealth Ontario) gives free nurse advice 24/7 at 1-866-797-0000.

Making sure you get the care you need

Coming here first is about access: getting the care the problem actually needs, straight away.

Most of the time that care is here. We examine the eye, make the diagnosis, and start treatment. We image the eye here too — OCT and retinal photography are part of how we work up an urgent problem, and they are often what identifies the thing that needs a specialist in the first place.

Sometimes it involves things beyond our scope of practice. When it does, we liaise directly with the appropriate specialist or urgent care service and send our findings with you, so the next step is set up rather than left for you to arrange. What no clinic can provide is a CT or MRI, intravenous medication, urgent surgery, or admission — that is what a hospital is for.

Find your symptom

• Red eye - optometrist, walk-in clinic, or emergency room
• Blood in the white of your eye - almost always harmless
• Stye or swollen eyelid - and the swelling that is not
• Scratched eye - corneal abrasion and foreign bodies
• Floaters and flashes - sudden change needs same-day assessment

Related pages

• Floaters and flashes - when to worry - what causes floaters and when they need urgent assessment
• Urgent eye care - what we assess and what to bring
• Do I need an appointment? - how walk-ins and urgent problems are handled
• Office hours and holiday hours
• How to get to Spadina Optometry