Acute Ophthalmology in the Emergency Department

Why This Study Day Matters to Your Career

There is real trepidation when it comes to acute ophthalmology in ED, with most having never been exposed to these conditions or the procedures of removing a corneal foreign body with a needle or performing lateral canthotomy, let alone knowing when these interventions are actually indicated. This is quite understandable: training often provides limited hands-on exposure to eye care, and the combination of diverse presentations and specialized tools can make these cases seem intimidating.

Yet ophthalmic presentations are common in emergency departments, and though true ophthalmic emergencies are relatively few, it is absolutely critical for the emergency clinician to recognize those conditions where immediate action preserves sight. The difference between prompt recognition and delayed management can literally mean the difference between vision and blindness for your patient. A seasoned ED clinician should have the ability to quickly recognize and appropriately manage these sight-threatening conditions, and it is essential for career progression in emergency medicine.

At British Medical Courses, we have created something very different from the usual acute ophthalmology training. Our study day is developed by Ophthalmologists and ED Consultants with special interest in and vast experience in managing acute eye-related problems in the emergency department. This unique collaboration ensures you receive both specialty-level ophthalmological expertise and practical emergency medicine wisdom from clinicians who understand the realities of ED practice.

You will approach various real-life acute ophthalmology scenarios with a completely different approach, making the management of ophthalmic cases in the ED more accessible by systematic assessment and focusing on key skills. We believe in one-on-one learning with tailor-made plans to address only your anxieties and skill deficits, including practical procedural guidance. By mastering this key skill, you take a big leap ahead in your medical career and become an expert in dealing with acute ophthalmology in ED, approaching these presentations with confidence rather than trepidation. We teach you what other courses can't: the practical approach that transforms ophthalmology from an intimidating specialty into a manageable and even satisfying aspect of emergency practice.

Who Will Benefit from This Study Day

This study day is a must for emergency medicine clinicians at all levels who would like to replace ophthalmology anxiety with competence. You will benefit immensely if you're a junior doctor who has never removed a corneal foreign body or feels uncertain about when to urgently involve ophthalmology services versus managing conditions in the ED.

This course will be particularly useful for emergency medicine trainees developing their broad skills in all emergency presentations. The systematic approach to acute eye complaints gives a framework that makes these very diverse presentations far less daunting and more diagnostically accessible. If you've ever felt paralyzed when faced with a red eye, unsure whether it represents a benign condition or sight-threatening emergency, this study day provides the clarity and confidence you need.

Physicians in acute medicine, general practitioners with emergency department sessions, urgent care practitioners and advanced clinical practitioners who work in acute settings encounter eye complaints on a regular basis. Emergency nurses wanting to enhance their assessment skills and appreciate when escalation is urgent will also receive considerable benefit.

The practitioners with experience, but whose primary interests are other emergency presentations and who recognize that their ophthalmology knowledge needs to be refreshed, will appreciate the practical, procedure-focused approach. If you've been avoiding eye cases or routinely referring everything to ophthalmology without appropriate initial assessment and management, this course will transform your practice.

This comprehensive study day will therefore be of benefit to anyone who wants to develop the variety of differentials and the systematic approach that will maximize the chances of diagnosing and managing important ophthalmological conditions.

What Knowledge and Skills You Will Gain

This intensive study day equips emergency clinicians with the essential knowledge and hands-on skills to confidently assess and manage common and critical ophthalmic presentations in the Emergency Department (ED).

Systematic Assessment and Differential Diagnosis

Participants will learn a systematic approach to the acute red eye, including how to distinguish painful from painless presentations — a crucial step that directs urgency and management. Painful causes such as acute angle closure glaucoma, corneal ulcers, uveitis, and scleritis will be explored alongside painless conditions like conjunctivitis, subconjunctival hemorrhage, and episcleritis.

Practical Procedural Skills

Corneal foreign body management will be taught through practical demonstration, including removal techniques, use of local anesthesia, post-removal care, and indications for ophthalmology referral. A practical overview of lateral canthotomy will provide life-saving skills for orbital compartment syndrome — emphasizing when and how to act immediately.

Common Presentations

The course covers acute conjunctivitis — differentiating viral, bacterial, and allergic causes, choosing appropriate investigations, antibiotic selection, and recognizing complications such as corneal involvement. Beyond conjunctivitis, clinicians will explore serious ocular infections including keratitis, uveitis, and endophthalmitis, learning to recognize presentations, initiate urgent investigations, and deliver timely management.

Sight-Threatening Emergencies

You will gain a deep understanding of acute angle closure glaucoma, a sight-threatening emergency, including clinical recognition, intraocular pressure assessment, and immediate pharmacological management prior to ophthalmology referral. The session on acute visual loss will help clinicians differentiate painful from painless causes — ranging from optic neuritis and temporal arteritis to retinal detachment and vascular occlusions — ensuring time-sensitive intervention to preserve vision.

Trauma and Injuries

Globe rupture and penetrating eye injuries will be discussed with emphasis on red-flag features, safe handling (avoiding pressure or manipulation), protective measures, antibiotic use, and the importance of urgent surgical consultation. The eye trauma component covers injury mechanisms, hyphema, orbital fractures, chemical injuries, and imaging strategies, including when CT or ultrasound is appropriate.

Retinal Conditions

Retinal detachment and floaters will be addressed in depth, focusing on identifying alarming symptoms such as flashes, floaters, or shadows, and distinguishing benign conditions from sight-threatening emergencies.

Diagnostic Skills

Participants will also improve confidence in fundoscopy, an often-underused but invaluable diagnostic tool, with guidance on performing and interpreting findings relevant to papilledema, retinal hemorrhage, and retinal artery occlusion.

Clinical Judgment Development

Finally, the course emphasizes clinical judgment — deciding when to manage cases in ED, refer urgently, or arrange routine follow-up — ensuring patient safety while optimizing resource use.

Certification and Validation

By the end of this program, attendees will have the confidence and competence to manage ophthalmic emergencies effectively. A mock exam and certification will conclude the day, validating participants' expertise in acute ophthalmology within emergency medicine.