Do I need an ophthalmologist or an optometrist?

February 17, 2016 2:45 PM

I think I might suddenly need glasses, and have a few questions. I don't think I'll be able to have an eye exam until Friday. I started noticing pain in one eye last week--it sort of feels like the eye muscle is straining to focus, and it really hurts. I also noticed that if I cover each eye, the opposite eye has blurry vision (though with both open, things are only slightly blurry). Do I just need a standard eye exam, or should I book an appointment with an opthalmologist? I don't really know the difference, and spending time googling is painful for my eyes right now. Other info: I have to work long hours on a computer. I've had horrible insomnia over the last week, and have been taking Benadryl to try to help me sleep, which I know can dry the eyes. I've never worn glasses before.
posted by three_red_balloons to Health & Fitness (26 answers total)

You should see an Ophthalmologist and you should do it tomorrow. I am not a panic-er but your eyes should never "really hurt."
posted by DarlingBri at 2:48 PM on February 17, 2016 [9 favorites]

Pain? Opthalmologist, ASAP. This isn't a problem of finding corrective lenses. The symptoms are worrisome and some eye problems can progress fast - best to have them looked at soon.
posted by Miko at 2:51 PM on February 17, 2016 [3 favorites]

This is a medical issue with your eyes. Ophthalmologist - a medical doctor who specializes in eyes - is who you need to see - and pronto.
posted by leslies at 2:53 PM on February 17, 2016 [1 favorite]

Emergency room, now. Vision changes and intense eye pain are an emergency. Data point: I take Benadryl to sleep on occasion, chronically under-sleep, and I use a computer constantly.. yet I have never had symptoms like you describe- they sound serious.
posted by pseudostrabismus at 2:57 PM on February 17, 2016 [6 favorites]

Perhaps you have eye strain. If looking at things far away instead of close up makes your eyes feel less in pain, stop looking at close up things for a while. I had similar symptoms and spending less time in front of a screen or reading a book relieved them. I don't want to dissuade you from going to an ophthalmologist, but that's something you can try in the short term.
posted by demiurge at 2:58 PM on February 17, 2016

It's possible that this is just a sinus thing. I've definitely gotten slightly blurry vision on one side when I've had heinous sinus issues but also agreeing with people, eyes shouldn't really hurt like that and if it's too painful to read, I'd be going to Urgent Care somewhere.
posted by jessamyn at 2:59 PM on February 17, 2016

Seconding ER now. Two different friends have had similar symptoms and would have suffered permanent visit loss if they hadn't gone to the doctor.
posted by Blue Jello Elf at 3:00 PM on February 17, 2016 [1 favorite]

Definitely go to a doctor and not an optometrist - if I were you, I'd call opthamologist offices and see if you can find one with an opening today - if you're in a big US city, try zocdoc to search by specialty, insurance, and appointment time at the same time. If you can't find an opthamologist, go to a regular doctor (who can help diagnose conditions that have vision problems as a symptom) rather than going to an optometrist (who can only calibrate glasses for blurry vision).

I experience all kinds of weird vision problems when I haven't slept enough, and I know others who are the same way. The insomnia may actually be causing this, so I wouldn't freak out too much (but I'm not a doctor and go see one anyways).
posted by R a c h e l at 3:11 PM on February 17, 2016

Response by poster: It feels sort of like a strained muscle--I haven't had eye strain before, but I was assuming that is what this feels like. I have anxiety and your answers are kind of freaking me out--I'm trying to get an appointment as soon as I can, but would appreciate hearing from anyone else who's had eye strain. There aren't any openings with opthamologists with my insurance until Friday, but I could go to urgent care tonight (though I just called them and I would be seeing a primary care doctor, not an eye doctor).
posted by three_red_balloons at 3:16 PM on February 17, 2016

Eye strain does not feel like a strained muscle, and it doesn't cause pain in your eye. It's more like your eyes feel tired, or itchy/burning like you need to rub them, and you might get a little headache.

It could be sinus related, it could be more serious. You say you feel like you "suddenly" need glasses -- has your vision changed dramatically since the pain started? "You have sudden blurred vision with eye pain" is one of the "see a medical professional now" items on the U.S. National Library of Medicine's Medline page for vision issues.

If I was in your shoes, I'd call the opthamologist office where you have an appointment and ask their advice -- describe your issues, and ask if you should come in sooner or if they believe Friday would be okay. If they think you should go to urgent care, they'll tell you so.
posted by erst at 3:39 PM on February 17, 2016 [22 favorites]

erst is giving you excellent advice. Please take it.
posted by heyho at 3:43 PM on February 17, 2016

No appointment, get to the ER NOW!
posted by brujita at 3:48 PM on February 17, 2016

Yes, erst's idea to phone and ask for a recommendation is a great approach that should result in your either being calmed immediately, or seen soon.
posted by Miko at 4:00 PM on February 17, 2016 [4 favorites]

Bottom line, you probably need to be evaluated at an emergency department. If the providers in the ED feel that it is necessary, they can call an urgent consult for you to be evaluated by an ophthalmologist ASAP. I don't think going to urgent care is going to be the answer here.
posted by scalespace at 4:20 PM on February 17, 2016

If you have insurance there may be a 24/7 nurse line option on it where you can call someone and ask a professional "Do I need to go to the ER for this?" and they will give you professional advice.
posted by jessamyn at 4:58 PM on February 17, 2016 [8 favorites]

Response by poster: One panic attack later, I have a diagnosis of eyestrain and a doctor who told me there's no rush to see the ophthalmologist. All I can say is that I don't plan to ask the internet for medical advice again, and I'm done with Metafilter for now.
posted by three_red_balloons at 5:45 PM on February 17, 2016 [6 favorites]

People told you to make a call, and you made a call. That was sound advice. I hope you feel better very soon.
posted by heyho at 5:49 PM on February 17, 2016 [8 favorites]

Speaking as an anxiety-prone person myself, I sympathize with your situation, but the fact that you spoke to a doctor tonight seems to suggest that things are working as they should. You described symptoms that could potentially be serious to a bunch of remote and mostly lay-people, and asked what to do ... I kind of think any answer that didn't involve some form of "get professional advice quickly" would have been irresponsible. As you say, medical advice is probably best not gotten from the internet.

Anyway, I'm glad you updated to let us know you're okay.
posted by DingoMutt at 6:01 PM on February 17, 2016 [6 favorites]

All I can say is that I don't plan to ask the internet for medical advice again, and I'm done with Metafilter for now.

I think people were very cautious about not scaring you with information. Speaking only for myself, I did not point out that eye pain and blurred vision is symptomatic of Angle-Closure Glaucoma, which is a medical emergency. You asked if you should see an optomotrist or an ophthalmologist, and how soon, and "ophthalmologist, and immediately" is the only responsible answer you could have been given over the internet.
posted by DarlingBri at 6:57 PM on February 17, 2016 [7 favorites]

I'm so glad you went to the ER, and I'm even happier that it's "just" eyestrain. Sometimes anxiety can lead us to be overly worried but sometimes that intense concern is what keeps us safe. Please be gentler on yourself as well as on the people who recommended you go in. An accurate diagnosis that tells us things are much better than expected is never a bad thing!

I'm not risk-averse when it comes to a lot of things health-related: I will eat expired food, generally put off going to the doctor if I feel a little bump in hopes it'll get better, and often wait till the last minute to refill prescriptions. However, I never fuck around when it comes to my vision and with good reason.

A family member noticed vision changes and finally went to the ER, where they thankfully referred her to an ophthalmologist who correctly diagnosed a retinal detachment. Surgery followed immediately after and there was a long, complicated road to recovery; however, had she gone in even a few hours later, she would have gone completely blind in that eye. I once had a situation like yours where wanted it to be nothing and couldn't even get my (former) optometrist to see me for five minutes to give me the necessary referral. I went to the ER instead and the doctor there gave me the referral and it's good he did because I had a retinal tear. I now go to a practice with wonderful ophthalmologists who will always fit in me, retinal specialists who send annual reminders, and also a great optometrist who fits me for contacts.

Most people do not have such complicated eye problems like I do, fortunately. But it's important to have that team of experts and advocates if you do. I'd definitely keep that Friday appointment with your in-plan ophthalmologist so you can start forming a relationship now. They can often tell you if you're at risk for certain ailments, and will be available accordingly. It's really a win-win situation, even if your ocular health ends up being totally clear after today. (Bad pun intended!)

This summer I had an eye that hurt a little and was getting redder, so I finally went to urgent care since my GP wasn't available. I got a diagnosis of a mild eye infection and some drops. However, two days later and the eye was getting redder and the pain more intense. I didn't want to go in again but had advocates (family members) encourage me to see my ophthalmologist. Urgent care doctors and ER physicians know a lot but sometimes it's best to follow-up with a specialist, especially if things are not getting much better within a day or two. It turns out I had a very serious staph infection (and, apparently, a high tolerance for pain) and it was extremely important and good that I came in when I did. I got steroid drops, multiple follow-up appointments, and the like; I'm in the clear now, fortunately, and am even more careful than before. My doctors praised me for coming in and encouraged me to do so again immediately should I notice any eye issues in the future. It was a time where I thought I was being overly worried but that worry was actually spot on.

In other words, you did the right thing and I'm so glad you did. You can always see a psychologist if you're worried about your anxiety levels; it never hurts to have a wellness check. You don't have to come to Ask Metafilter for medical advice again but it's nice knowing there are people out there -- strangers even -- who take your medical concerns seriously and want the best for your health. Good luck!
posted by smorgasbord at 7:06 PM on February 17, 2016 [8 favorites]

There are lots of medical symptoms that can be either completely innocuous or very serious - and there's no way to know until you see an actual doctor. If you had a lump in your breast, it would almost certainly not be cancer, but it would be irresponsible for strangers on the internet not to tell you that it could be very serious and you must get it checked out. I'm sorry that you suffer from anxiety - I do as well - but helping you avoid possible blindness is going to trump trying to save you from a panic attack. I have gone to the ER on two occasions with eye problems that turned out to be minor - but the symptoms were exactly the same as those that could have led to complete loss of sight, and the ophthalmologists required me to have multiple follow-up visits just in case. You did the right thing by seeking medical treatment. It is just luck that the problem turned out to be eyestrain. I'm sorry that this caused you anxiety, but you were given the best possible advice.
posted by FencingGal at 7:27 PM on February 17, 2016 [7 favorites]

I've had a situation where I developed a new set of spots in my left eye and a feeling of eyestrain one afternoon at work. I managed to get an ophthalmologist's appointment that evening and left work a little early for it, and it turned out to just be a new rather large floater, which I still have.

Even though it didn't turn out to be a big deal, I felt much better to just know that, because it could've been something way worse. My eyesight is crucial to my livelihood, so it's important to me to know that it's OK. My father also has glaucoma and once had a failed cornea transplant after developing a cataract, and his subsequent vision problems have progressed to near-total blindness over the course of my lifetime. In my family, we don't fuck around with vision, and we believe it's always worth it to know what's going on with your eyes, even if you end up spending a little extra on it.

I think you did the right thing by going in, even if you're feeling frustrated right now.
posted by limeonaire at 8:55 PM on February 17, 2016 [1 favorite]

As someone who has been diagnosed as being at elevated risk of retinal detachment (i.e., the medical advice I have received from my doctors is "If you have sudden blurring/unusual floaters/flashing in your vision, go to an ER immediately"), and knowing that sudden blurring of vision could be sign of a stroke, nobody in this thread was overreacting.

My husband is blind, so me losing my sight suddenly would be a bit of a pain in the ass. Although we have plenty of white canes in the closet and I know how to use Voiceover on my iPhone if it came to that, I'd rather keep my vision to the extent I can.

Any and all advice saying "If you are experiencing sudden dramatic changes in your vision you should get it checked out ASAP and at an ER if you have to," is sound advice.

Any optometrist, opthalmologist or GP worth their salt will tell you the same thing.
posted by mandolin conspiracy at 9:46 PM on February 17, 2016 [1 favorite]

Most of the time, medical issues aren't pressing or serious. You asked if there was the possibility of it being a serious issue that needed attention -- and ask.mefi told you that yes, there was a possibility. That's not a negative against the community, it's a positive that you were motivated to see a professional that could examine you in person.

Nine times out of ten, it's not serious. The community told you that there is that tenth time.
posted by mikeh at 7:56 AM on February 18, 2016

I would add to DarlingBri's mention of Angle-Closure Glaucoma: Benadryl (and some other medications) can lead to an attack of angle closure in people who are physically predisposed to it, which made the description particularly scary, and "[r]apid and irreversible vision loss can occur if treatment is delayed" (source). This is the type of thing where I think it's better to have erred on the side of urgency.
posted by hsieu at 2:27 PM on February 18, 2016

Yeah, I noticed my eye was kind of blurry a few times and thought about making an appointment but it went away and I forgot about it. Until my retina detached, which led to emergency laser surgery where they sucked all the vitreous gel and liquid out of my eye and put a big gas bubble in there for the next nine weeks. The bubble gave me a cataract. I had to lie on my face 24/7 (no working or driving or anything) for 5 1/2 weeks so the bubble would hold my retina together. My doctor just had to cancel the cataract surgery because he found microscopic fluid bubbles in my retina so I have to be on medicine that makes my ears ring, my hands and feet tingle, makes me incredibly tired and (bizarrely) makes carbonated drinks taste like poison or something. I haven't really been able to see much out of my left eye since Halloween. Also, they hit some nerve with the laser so now that pupil doesn't dilate or contract or match the other one ever. So that's a good look.

In conclusion, going to the doctor when I noticed my eye was a teeny bit blurry would have been a really awesome decision.
posted by artychoke at 10:24 PM on February 18, 2016 [3 favorites]