Ophthalmology Pathways

Differential diagnosis and emergency referral criteria for acute red eye

Emergency recognition and stepwise IOP-lowering treatment for AACG, followed by laser iridotomy

Symptom-based urgency triage and surgical management pathway for retinal detachment

NHS diabetic eye screening grades, urgent referral criteria, and treatment options for diabetic retinopathy

Diagnosis, topical steroid treatment, and systemic investigation for anterior uveitis

Differential diagnosis pathway for acute painless visual loss — CRAO, CRVO, GCA, optic neuritis

Assessment, removal technique, and antibiotic prophylaxis for corneal foreign body

Sight-threatening intraocular infection — post-op, bleb-related, endogenous; immediate vitreous tap + intravitreal antibiotics.

Distinguish (preseptal — anterior to orbital septum, less severe; orbital — sight + life-threatening); CT, IV antibiotics, drainage.

Subacute painful vision loss + RAPD; investigate for MS / NMOSD / MOG; IV methylprednisolone for visual recovery.

Sudden painless vision loss — 'stroke of the eye'; cherry-red spot, RAPD; treat as stroke equivalent — refer hyperacute stroke pathway.

Sudden painless vision loss — 'blood and thunder' fundus; investigate cardiovascular + thrombophilia; anti-VEGF for macular oedema.

Sudden floaters / vision loss; absent fundal red reflex; identify cause (PVD, retinal tear, diabetic retinopathy, trauma); urgent vitrectomy if not clearing.

Acute painless vision loss in elderly + GCA features; urgent high-dose steroid (do NOT wait for biopsy).

Suspected globe rupture — eye shield, NIL by mouth, antibiotic, urgent ophthalmology surgical repair.

Alkali worse than acid (penetrates rapidly); IMMEDIATE copious irrigation regardless of cause; urgent ophthalmology.

Distinguish dry (no specific treatment, AREDS supplements) vs wet (anti-VEGF intravitreal); central vision loss; lifestyle.