Immediate, Expert Care for Eye Emergencies.

• Begin flushing your eye immediately with cool, clean tap water or sterile saline
• Hold your eyelids open and flush continuously for 15-20 minutes minimum (30 minutes for alkali chemicals like bleach, drain cleaner, oven cleaner, or ammonia)
• Remove contact lenses during flushing if wearing them
• Irrigate from the inner corner of the eye outward to avoid washing the chemical into the other eye
• Continue flushing during transport if possible

• Seek emergency medical care immediately. Go to the nearest emergency room or call 911.
• Bring the chemical container or label so the treating physician can identify the substance
• Your provider will check the pH of your eye and continue irrigation until it normalizes (7.0-7.2, per AAO guidelines)

Time to irrigation is the single most important factor in your outcome.

All chemical splashes need emergency evaluation. Alkali (basic) chemicals are the most severe ocular emergency because they penetrate deeper into eye tissue than acids and can cause progressive damage even after exposure.

• Severe burning pain
• Cloudy or white-appearing cornea
• Blurred vision
• Inability to keep the eye open

Even if symptoms seem to improve after flushing, you should still be examined because internal damage may not be immediately apparent.

Acid burns tend to cause more superficial damage because the acid coagulates surface proteins, forming a barrier that limits deeper penetration. Alkali chemicals do not self-limit and continue to destroy tissue long after exposure.

• Strong acids such as hydrofluoric acid and sulfuric acid can be just as devastating as alkali burns

Regardless of substance: flush first, seek emergency care immediately.

• Wash your hands thoroughly
• Avoid touching or rubbing the affected eye
• Remove contact lenses immediately if wearing them
• Do not use over-the-counter "redness relief" drops (they mask serious symptoms)
• Avoid sharing towels, pillowcases, or eye makeup

Call us for a same-day exam.

While mild viral pink eye can sometimes wait a day, seek immediate care for:

• Thick greenish-yellow discharge
• Extreme light sensitivity (photophobia)
• Deep or throbbing eye pain
• Any decrease in vision

These can indicate bacterial keratitis or a corneal ulcer, both of which can cause permanent scarring and vision loss within 24-48 hours if untreated. Contact lens wearers are at elevated risk for aggressive infections, including Pseudomonas keratitis.

Self-treating with steroid eye drops is especially dangerous:

• If the infection is caused by herpes simplex virus (a common and often unrecognized cause of eye inflammation), steroids allow the virus to replicate unchecked
• This can lead to severe corneal scarring and potential vision loss

Only use prescription eye drops under the direct guidance of your ophthalmologist after a proper examination and diagnosis.

• Blink several times to allow tears to naturally flush the eye
• Gently rinse with sterile saline
• Keep the eye closed or loosely shielded
• Call our office for immediate triage

• Rub your eye
• Attempt to remove an embedded object yourself
• Use cotton swabs, tissues, or tweezers on the eye surface

A corneal abrasion becomes a severe emergency if accompanied by:

• Extreme pain or severe light sensitivity
• Persistent sensation of something trapped under your eyelid
• Blurred vision

• Contact lens wearers face higher risk of aggressive infection (Pseudomonas keratitis)
• Plant material, tree branches, or fingernails carry higher risk of fungal infection, which is more difficult to treat

• Clear or dark fluid leaking from the eye
• Irregularly shaped or teardrop-shaped pupil
• Tissue protruding from the wound

This is a surgical emergency. Do not apply pressure, do not rinse, and do not remove any object from the wound. Place a rigid shield (such as the bottom of a paper cup) gently over the eye and go to the nearest ER or call 911 immediately.

• Stop driving or performing any dangerous activities immediately
• If vision suddenly goes dark, dim, or missing in one eye, go to the nearest ER or stroke-capable hospital immediately, even if it returns
• If you can reach us during business hours, call (973) 742-4747 on the way

Go directly to the nearest emergency room (ideally one affiliated with a stroke center) without delay. Do not wait for the next business day.

Sudden blurriness, missing areas in your field of vision, or total blindness in one eye can indicate:

• Retinal artery occlusion (CRAO) - classified as a stroke by AHA and AAO
• Retinal detachment
• Acute angle-closure crisis

A central retinal artery occlusion (CRAO) is one of the most time-sensitive eye emergencies. The AHA and AAO classify it as a form of stroke because the retina suffers irreversible damage when blood supply is blocked. Rapid evaluation at a stroke-capable facility is critical. Delaying care can result in permanent, irreversible vision loss.

Temporary vision loss lasting seconds to minutes (amaurosis fugax) may feel harmless, but it is still urgent and a serious warning sign of:

• Transient blockage in blood supply to your eye or brain
• Significantly increased risk for full stroke or permanent retinal artery occlusion

Go to the ER or a stroke-capable hospital immediately, even if your vision has returned to normal.

• New headache with sudden vision loss
• Scalp tenderness
• Jaw pain when chewing

These may indicate giant cell arteritis, requiring urgent corticosteroid treatment to prevent permanent bilateral blindness. Seek care the same day.

• Do not panic, but do not ignore it
• Call our office immediately for an urgent same-day dilated eye exam
• Until your exam, it is reasonable to avoid heavy lifting or straining as a precaution

While a few gradual, small floating specks are normal with aging, seek immediate care for:

• A sudden shower of new floaters
• Lightning-like flashes of light in your peripheral vision

A sudden shower of floaters or flashes can signal a retinal tear and needs a same-day dilated evaluation. Retinal tears require prompt treatment (typically laser or cryotherapy) before the retina fully detaches, which requires surgery.

The most common cause is posterior vitreous detachment (PVD), where the gel-like vitreous humor naturally shrinks and separates from the retina.

• Increasingly common after age 60; affects most people by age 70
• Usually harmless on its own, but can create retinal tears
• AAO recommends follow-up exam within ~6 weeks (sooner if new symptoms develop)

• Nearsighted (myopic) patients
• Patients who have had cataract surgery
• Those with family history of retinal detachment

• Gently place a cold compress over the brow and cheek area
• Or place a rigid protective shield (like a paper cup bottom) over the eye without pressing on the eyeball
• Do not take aspirin or ibuprofen (they inhibit clotting and increase internal bleeding)
• Keep your head elevated, even when sleeping
• Call us immediately

• Deep, throbbing eye pain
• Pain when moving your eyes
• Severe pain with nausea, vomiting, and halos around lights (hallmark of acute angle-closure crisis)

Watch for blood pooling in the front of the eye (hyphema), visible as a red layer between the cornea and iris. Hyphema requires close monitoring to prevent dangerous pressure spikes. Deep internal pain or visible changes after trauma require high-priority medical care.

Yes. Blunt trauma can cause an orbital fracture (break in bones surrounding the eye socket).

• Double vision
• Difficulty looking upward
• Numbness in the cheek or upper lip
• Sunken appearance of the eye
• Significant swelling limiting eye movement

• Rapidly worsening pain
• Rock-hard swollen eyelid
• Vision loss after facial trauma

This may indicate orbital compartment syndrome, which can cause permanent vision loss within a very short time and needs immediate emergency treatment.

• Gently flush with clean water or sterile saline
• Pull the upper eyelid over the lower to encourage tears to wash it out
• Do not rub your eye (pushes objects deeper or scratches cornea)

• The object does not flush out easily
• It was propelled at high speed (grinding, hammering, weed-whacking, power tools)
• It feels stuck

Any foreign body from a high-velocity source is a true emergency, even with only minor irritation:

• Metal grinding, hammering metal on metal, drilling, or power tool use
• Small metallic fragments can penetrate the eye wall and lodge inside without causing initial severe pain

• Devastating infection (endophthalmitis)
• Toxic reactions within the eye
• Retinal damage

An urgent exam with possible imaging is needed to rule out a penetrating injury.

If a metallic particle lands on your cornea and remains for even a few hours, it can begin to oxidize, leaving behind a rust ring that:

• Causes persistent irritation
• Delays healing
• Can lead to scarring if not professionally removed

Your ophthalmologist can safely remove both the foreign body and the rust ring using specialized slit-lamp instruments. Do not attempt removal at home.

• Severe pain, tearing, light sensitivity
• Gritty or "sandpaper" sensation
• Redness

• Remove contact lenses if wearing them
• Apply a cool, damp cloth over closed eyes for comfort
• Avoid rubbing your eyes
• Use preservative-free artificial tears if available
• Call our office for same-day evaluation

If symptoms occurred after looking at an eclipse or intense light source, mention this specifically as solar retinopathy requires different evaluation.

Most UV keratitis from a single exposure heals within 24-72 hours with proper care, but requires professional evaluation to:

• Rule out corneal damage
• Manage pain appropriately
• Prevent secondary infection

• You experience vision loss
• Both eyes are severely affected
• Symptoms worsen after 24 hours

Repeated UV exposure without protection contributes to pterygium and cataracts over time.

Thermal burns from hot liquids, steam, curling irons, hot grease, fireworks, or open flames can damage the eyelids, cornea, and surrounding tissue.

• Flush gently with cool (not ice-cold) water
• Do not apply ointments or butter
• Cover loosely with a clean, non-adherent dressing
• Seek immediate care

• Eyelid burns can prevent proper eye closure, leading to chronic corneal exposure
• Firework injuries are especially dangerous (combine thermal, chemical, and penetrating mechanisms)

• Remove the lens immediately; do not reinsert it
• Place the lens in its case with solution (your doctor may want to culture it)
• Rinse your eye with sterile saline or preservative-free artificial tears
• Do not switch to a backup pair of contacts; wear glasses instead
• Call our office for an urgent evaluation

Contact lens wearers are at increased risk for bacterial corneal ulcers that can progress to vision-threatening levels within 24 hours.

• White or gray spot on the cornea (visible in a mirror)
• Pain that worsens after lens removal
• Significant vision decline
• Copious discharge

• Sleeping in contact lenses
• Swimming or showering while wearing them
• Using tap water to rinse lenses

Acanthamoeba keratitis, a rare but devastating parasitic infection linked to water exposure, can require months of intensive therapy.

A contact lens cannot slip behind your eye. The conjunctiva forms a sealed pocket that prevents this.

• Apply several drops of preservative-free lubricating drops or saline
• Close your eye and gently massage the eyelid to rehydrate the lens
• Wait a few minutes, then try to locate and remove it

If you cannot find or remove the lens after several attempts, or if your eye is painful or red, come in so we can safely locate and remove it with a slit-lamp microscope.

• Apply gentle pressure with a clean cloth to control bleeding
• If tissue is partially detached, do not pull it away
• Cover the area with a clean, damp gauze or cloth
• Seek immediate medical care

• Press directly on the eyeball
• Attempt to clean deep wounds
• Remove debris from a laceration
• Apply antibiotic ointment inside the wound

Eyelid lacerations require specialized repair by an ophthalmologist or oculoplastic surgeon, not a general ER physician, whenever possible.

• Laceration involving the eyelid margin (where lashes grow)
• Laceration near the inner corner of the eyelid (tear drainage system/canaliculus)
• Full-thickness wound through the entire eyelid

• Chronic tearing
• Eyelid malposition
• Incomplete eye closure
• Corneal damage

If you suspect the eyeball was cut or punctured during the injury, treat it as an open globe emergency: shield without pressure and seek emergency care immediately.

All eyelid lacerations in children should be evaluated by an ophthalmologist, even if they appear minor.

• Children are less able to communicate the severity of their symptoms
• Small external cuts may involve deeper structures
• Dog bites to the eyelid are especially common in young children and frequently involve the tear drainage system

Repair is typically performed under general anesthesia and should ideally occur within 24-48 hours for the best functional and cosmetic outcome.