When is a painful red eye urgent?
Share
Quick answer
A painful red eye needs urgent assessment when vision is reduced, light hurts, the cornea looks cloudy, there was an injury or you recently had eye surgery or an injection. A red or painful eye in a contact-lens wearer needs urgent same-day ophthalmic review; if this cannot be arranged immediately, go to an emergency department.
A painful red eye is not always conjunctivitis. Pain, reduced vision, light sensitivity, contact-lens wear, injury and recent eye treatment can signal problems that need urgent assessment.
When is a painful red eye an emergency?
Seek emergency medical care if a red or painful eye occurs with:
- sudden severe or persistent loss of vision;
- a chemical splash, burn or penetrating injury;
- severe pain after recent eye surgery, laser treatment or an injection;
- a severe headache, nausea or vomiting with marked visual change; or
- possible stroke symptoms such as facial drooping, arm weakness or trouble speaking.
Other urgent warning signs include marked light sensitivity, a cloudy or abnormal-looking cornea, blood in the eye, a newly irregular pupil, or symptoms that are rapidly worsening.
Why is a red eye more urgent for contact-lens wearers?
Contact-lens wear increases the risk of corneal infection. NSW eye-emergency guidance states that a contact-lens wearer with a red or painful eye—or a change in vision—needs urgent ophthalmic review. This should be arranged the same day; if immediate ophthalmic assessment is unavailable, go to an emergency department.
Remove the lenses if they come out easily, do not put them back in, and avoid using leftover prescription drops. Tell the clinician what type of lenses you wear, whether you slept or swam in them, and how long the current pair had been worn.
What can cause a red and painful eye?
Several conditions can look similar without a proper examination. Possible causes include a corneal abrasion or foreign body, corneal infection, inflammation inside the eye, acute angle-closure crisis, scleritis and complications after eye treatment. Conjunctivitis may cause redness and discharge, but prominent pain, light sensitivity or reduced vision is not typical of a simple irritation and should be assessed promptly.
An online description cannot safely distinguish these causes. An eye examination may include vision testing, pupil assessment, microscope examination and dye to check the corneal surface.
What should you do while arranging assessment?
- Stop contact-lens wear.
- Do not rub or press on the eye.
- Do not use another person’s drops or old prescription medication.
- Do not drive if vision is reduced or light sensitivity is severe.
- If a chemical is involved, start continuous water irrigation immediately and follow our chemical-eye first-aid guidance.
Can City Optics assess a red or painful eye?
Our optometrists can provide assessment for many eye concerns when a clinician is available. Contact your nearest practice and mention pain, vision change, light sensitivity, discharge, contact-lens wear, injury and recent procedures. A contact-lens wearer with a painful or red eye needs urgent same-day ophthalmic assessment; if the practice cannot provide immediate assessment, go to an emergency department. You can learn about our contact-lens fitting service and eye disease screening.
For emergency warning signs, do not wait for a routine booking. Use the emergency pathway in our urgent-eye guide.
Frequently asked questions
Is a red eye without pain urgent?
Mild redness without pain or vision change is often less urgent, but it still needs assessment if it persists, worsens, produces coloured discharge or occurs after an injury. Newborn babies with a red or discharging eye require urgent medical care.
Should I use antibiotic eye drops I already have?
No. Different causes require different treatment, and some drops can mask or worsen serious disease. Use medication only as directed for the current episode by a qualified clinician.
Can I wear glasses while my eye is red?
Glasses are generally preferable to contact lenses while symptoms are being assessed. Do not resume lens wear until your clinician says it is safe.
What information should I give the clinic?
Explain when symptoms started, whether one or both eyes are affected, whether vision changed, the severity of pain, light sensitivity, discharge, contact-lens use, injury and any recent eye procedure.
This general information does not replace an individual eye examination or medical advice.
