Eye emergencies

Treating walk-in eye emergency service

Contacts

  • Eye department
    St Thomas' Hospital
    Ground floor, South Wing, staircase C
    Westminster Bridge Road
    London SE1 7EH

    Reception tel: 020 7188 4316

    Advice helpline: 020 7188 4336

  • South WingDownload map to the eye emergency clinic (PDF 138Kb)

Opening times

  • Monday to Friday, 8.45am-4pm
  • Outside of these hours, patients can be seen in the emergency department (A&E) at St Thomas’ Hospital.

If your condition is urgent, and you have been experiencing symptoms for less than five days, please come to the walk-in emergency service.

If you have previously seen your GP or optometrist as part of the minor eye conditions services (MECS), please bring your referral letter.

Please note patients are assessed and the most serious cases are seen first.

  • What is an eye emergency?

    Eye emergency for patients include:

    • chemical injury splashed in the eye
    • an injury involving severe trauma or penetrating injury to the eye ball, lids or socket often by metal or a sharp object
    • recent onset of shadows or ‘curtaining’ curtain coming over vision, often with flashing lights and floaters
    • sudden onset of red and painful eye, particularly if associated with wearing contact lenses
    • sudden loss of vision with or without pain and sickness
    • swollen, painful, red eye with blurred or double vision and generally unwell, especially in a child (orbital cellulitis)
    • double vision with headache, droopy eye lid can have large pupil
    • losing vision with severe headache
    • suddenly seeing persistent floaters or flashing lights
    • sudden loss of vision then optometrist diagnosis of bleeding within eye if not-diabetic
    • optometrist diagnosis very high eye pressure
    • severe or chronic conjunctivitis eye infection with pus
    • child with consistent white pupil (within seven days)
    • loss of central vision with optometrist suspecting wet age-related macular degeneration (AMD) (within 14 days).
  • Eye emergencies for postoperative patients

    If you have recently had eye surgery and have:

    • an increasingly painful eye with severe reduction or loss of vision blind or painful eye which causes sickness and general malaise
    • an unexpectedly painful, red, or swollen eye with reduced vision
    • corneal graft patients who are losing vision.
  • Minor eye conditions service (MECS)

    The minor eye conditions service (MECS) is a free NHS service available to people aged six years and over who live in Lambeth, Southwark and Lewisham and are registered with a GP.

    Conditions treated include:

    • dry, gritty, irritable and uncomfortable eyes
    • foreign body in the eye
    • red eye or eyelids
    • ingrowing eyelashes
    • watery discharge
    • recent and sudden changes in vision.

    Contact a MECS registered optician in your area, who will assess how quickly you need to be seen by the service.

    This service is not for major eye conditions such as cataracts, diabetic retinopathy or glaucoma, but can refer patients to other services if necessary or urgent.

  • Referral information for GPs

    Patients who are referred urgently will be seen two to six weeks after their referral has been received, depending on the condition (decisions are based on the assessment of the referral letter content).

    Where there is a high level of urgency, referral letters must include a detailed history and full clinical findings to support the case to be seen more urgently.

    Please see our referrals page for more information.

    GPs and optometrists can refer patients with the following:

    • chemical injury to eye or lids (acid or alkali)
    • an injury involving severe trauma or penetrating injury to the eye ball, lids or socket by severe traumatic injury or retrobulbar bleed
    • sudden onset of painful eye with severe reduction or loss of vision blind or painful eye which causes sickness and general malaise (eg acute      glaucoma, severe uveitis, blebitis)
    • after an eye operation, an unexpectedly painful, red, or swollen eye with reduced vision (eg endophthalmitis, severe post-operative uveitis)
    • patients with any eye symptoms following corneal graft surgery (graft rejection)
    • recent onset of shadows or ‘curtaining’ in the field of vision, typically associated with flashing lights or an increase in seeing floaters (retinal      tear/ detachment)
    • sudden onset of red and painful eye, particularly if associated with wearing contact lenses (eg corneal ulcer with/without hypopyon)
    • sudden loss of vision with no other symptoms (eg retinal/ optic nerve vascular or inflammatory event)
    • a swollen, painful, red eye with blurred or double vision and malaise, especially in a child (orbital cellulitis)
    • ptosis, headache and diplopia – (third nerve palsy posterior communicating artery aneurysm)
    • headache +/- loss of vision – (eg giant cell arteritis)
    • recent onset persistent floaters or photopsia with no visible break on dilated SLBIO
    • vitreous haemorrhage in a non-diabetic patient
    • elevated IOP in eye with narrow van Herick but normal pupil and clear cornea
    • severe or chronic conjunctivitis
    • child with consistent white pupil reflex (retinoblastoma) – flag as ‘very urgent <1 week’ rather than emergency
    • suspect wet AMD use the NICE two-week referral pathway.