ABSTRACT
Visual disturbance is one of the cardinal symptoms of pathology in the eye. Visual acuity should be checked in all patients who attend the A&E department with symptoms related to the eye. The absence of visual symptoms is usually good confirmatory evidence of a diagnosis of conjunctivitis in a patient with a red eye. Episcleritis is a painful inflammatory nodule often associated with rheumatic disorders. They may cause short-term visual impairment. They characteristically produce a 'starry night' appearance on corneal staining due to multiple small erosions. Retinal detachment is more common in the myopic eye. It may be primary idiopathic or secondary to intraocular tumour, fibrous bands in diabetes or trauma. Fifty per cent of patients have the sensation of flashing lights or retinal spots before detachment. Acute angle closure glaucoma is a condition of middle to later life characterized by painful loss or reduction of vision.
