Ophthalmic emergencies are serious diseases or injuries to the eye that require immediate treatment and, if necessary, further evaluation in the hospital.
The symptoms described below are indicative of a typical pediatric ophthalmic emergency in previously healthy children. Atypical cases, as always in medicine, are rare but possible. If you feel that you have an ophthalmic emergency in your child, or if you are not sure if it is an emergency, please call our office. We will be happy to discuss the situation with you and to give you an urgent examination appointment for your child.
For emergencies that require further clarification, we will contact your child’s pediatrician and work closely with the acute care hospitals in the city of Zurich (Eye Clinic of the University Hospital Zurich and the Children’s Hospital Zurich).
A red eye is a common issue in children. In most cases, conjunctivitis, for example due to viruses, is the cause. However, if there is no clear connection to a cold and if there are additional symptoms such as involvement of the cornea or at the edge of the cornea, swelling of the eyelid, bumps on the conjunctiva, rashes around the eye with blistering, a decrease in vision, a new sensitivity to light, or an increase in temperature/fever with fatigue, then an immediate ophthalmologic examination should be done.
A strabismus can have different causes in children. A new strabismus should always be urgently examined orthoptically and ophthalmologically. Rarely, a life-threatening cause may be the reason or a neurological disease that requires immediate evaluation and treatment.
If your child reports sudden visual disturbances, there can be many causes. Harmless causes are possible, however, an urgent ophthalmologic examination should be performed to rule out an emergency. Sometimes an additional neuropediatric evaluation is necessary.
If headache with vomiting is present, especially in the morning or at night and without gastrointestinal infection, it should be taken very seriously and urgent pediatric evaluation should be performed. An ophthalmologic examination is also useful to rule out optic nerve changes (papilledema) or eye muscle paralysis as signs of a central cause. Minimal initial such changes can usually only be detected by an ophthalmologist. If there are clear signs of this, we immediately contact the neurology department of the Children’s Hospital in Zurich so that urgent further clarification can take place.
A pupil that lights up white in light, a so-called leukocoria, is an alarm sign of a potentially life-threatening change at the back of the eye, especially in infants and young children. Fortunately, leukocoria is rare. In addition, screening examinations are performed as part of pediatric eye care, so affected children are usually detected early. However, if you notice a new whitish change in one eye or both pupils, please contact us immediately for an ophthalmologic examination.
Unevenly sized pupils are very common in the population. Most of the time it is a normal finding. Unequal pupil size can be present from birth. However, if the difference in pupil size changes significantly, especially in infancy or toddlerhood, and/or the palpebral fissure width also changes, this is an indication of a rare pediatric ophthalmologic emergency.
Children are lively and active. Accidents in childhood can lead to serious injuries to the eyes and reduce vision in the long term.
Falls to the head and midface, for example, can result in bony injuries to the orbit with entrapment of external eye muscles and double vision.
Eyeball contusions can result in any type of injury to the anterior or posterior segment of the eye. Bleeding can often be seen as red or bluish areas around the eyes or on the conjunctiva on the surface of the eye. Also, if children report vision loss with the affected eye or pain after an accident, this should also be cause for prompt ophthalmologic examination.
However, because many young children often do not express symptoms and injuries to the eye are often not obvious, an ophthalmologic examination should always be performed after a fall to the midface, bleeding around and in the eye associated with an accident, and bruising of the eyeball. In eye accidents, and even fractures of the bony orbit, children’s eyes are often not as red as one might expect as an adult.
In the case of injuries with blunt objects (for example, with a ball, pencil, toy), which can cause injuries to the eye due to compression, an orthoptic and ophthalmologic examination reveals new eye movement disorders and injuries to the anterior and posterior segments of the eye that require treatment.
If an injury with a sharp or pointed object (for example, knife, scissors, fork, nail) is suspected or cannot be ruled out, an immediate ophthalmologic examination should always be performed.
We will be happy to arrange an appointment with you that suits you well in terms of time.
In case of emergency (especially in case of: sudden vision loss, acute pain or inflammation of the eyes, new strabismus, accidents) please call us so that we can give your children or you an urgent appointment.
