Written by Dr Sing-Pey Chow (CORNEA, CATARACT AND REFRACTIVE SURGEON)
Australian Ophthalmologist Dr John Colvin AM (1929-2005) developed thirty-five ‘Golden Eye Rules’ to teach medical students, and his lectures were legendary for the use of trumpets, bongo drums and a gong to herald each teaching point! I have summarized these principles into five practical points:
ONE: Beware of the unilateral red eye. This can sometimes be due to a serious underlying ocular condition such as a corneal ulcer or infection, intraocular inflammation (uveitis) or acute angle closure glaucoma. This is particularly important if the patient is a contact lens wearer or has had recent trauma.
TWO: Any blurred vision requires prompt investigation.
Flashes, floaters and visual field defects may be signs of a retinal detachment and prompt treatment can lead to better outcomes. There are three vitreo-retinal surgeons at Terrace Eye Centre, ensuring that there is always someone available for retinal emergencies throughout the year.
THREE: Refer any squint (strabismus) or new onset diplopia. This could signal an underlying cranial nerve palsy, an intraocular or orbital pathology, and warrants prompt investigation. Any child with a squint or ‘lazy eye’ should be assessed by an Ophthalmologist as timely treatment of amblyopia is important in preventing visual loss.
FOUR: Beware of herpes zoster ophthalmicus (HZO) if the nose is involved. This is because the nasociliary branch of the trigeminal nerve innervates the cornea as well as the tip and side of the nose. Any patient with HZO and ocular symptoms should have a comprehensive eye examination.
FIVE: Topical steroids can be dangerous. It should never be initiated in a patient with suspected herpetic eye disease without first being seen by an Ophthalmologist, as this can lead to corneal perforation. Other potential side effects include cataract formation, raised intraocular pressure or glaucoma, and worsening of fungal corneal infections.
We are always happy to see any patient with a visual or ocular concern, and it is always better to seek a specialist assessment rather than wait and worry. We have appointments available for patients to be seen at short notice.