Eye symptoms that need urgent clinical handover

Some eye symptoms require prompt clinical attention. Support staff do not need to determine the cause. The appropriate action is to recognise when a presentation should not be handled routinely and to hand it over without delay.

Patients often minimise symptoms because they are busy, worried about cost, embarrassed, unable to travel or unsure whether an optician can help. Support staff should keep such concerns visible until a clinician or an established urgent route takes over.

Escalate promptly if someone describes

• Sudden sight loss or change: sudden loss, distortion, blurring, darkening or dimming of vision in one or both eyes.
• Flashes, floaters, curtain or shadow: particularly if new, sudden, increasing or accompanied by blurred vision or pain.
• Painful red eye: especially with light sensitivity, reduced vision, headache, nausea, contact lens wear or recent surgery.
• New double vision: new or sudden double vision, new squint, drooping eyelid or pain on eye movement.
• Severe headache with eye symptoms: especially when combined with nausea, vomiting, eye pain, visual change or other neurological signs.
• Post-operative concerns: new pain, discharge, change in vision or a hospital instruction to seek urgent help.

What not to do

Do not tell the patient their symptoms are probably normal, probably just eye strain, probably dry eye or probably caused by their glasses. Avoid offering clinical explanations to reassure them; reassurance can be unsafe if it delays urgent assessment.

Do not judge urgency solely by the patient's demeanour. A calm patient may have a serious condition, and an anxious patient still needs an appropriate route for assessment.

Clinical and regulatory guardrails

Support staff do not choose the diagnosis or referral urgency. They keep urgent symptoms moving to the right person or route.