Sudden loss is an emergency
Painless sudden monocular loss, a curtain descending, flashes with new floaters, or loss with pain and halos each route straight to emergency care with the pathway named.
Specialty · Ophthalmology
Sudden vision loss is triaged in seconds.
Acuity-led triage that separates the sight-threatening from the routine, injection clinic scheduling that holds its interval, and post-operative follow-up for cataract and retinal surgery.
- < 30s
- Sudden vision loss to emergency routing
- 95%
- Injection intervals kept within window
- 3.3x
- Post-operative checks completed
In the product
Eye line — inbound 08:52
EmergencyInbound 08:52 · Ruth C. · 66 · pseudophakic right eye · no recent surgery
Caller
There's a shadow across the bottom of my left eye. It came on yesterday evening and it's bigger this morning.
Primum
Is it painful, and have you seen any flashes of light?
Caller
No pain. There were flashes on and off for a couple of days before, like a camera going off.
Painless progressive field loss + preceding photopsia → retinal detachment pathway
Primum
You need to be seen today at the emergency eye service, not at a routine appointment. Don't drive — arrange a lift. I'm sending the address and letting them know you're coming.
Acuity triage
- Onset
- Yesterday evening, progressing
- Pain
- None
- Photopsia
- 2 days preceding
- Laterality
- Left, monocular
- Pathway
- Suspected detachment
- Destination
- Emergency eye service, today
Service notified 08:55 · transport advice given · chart coded
Overview
In this specialty, hours decide whether sight comes back.
- Sudden, painful and monocular findings route to emergency care within the call.
- Injection intervals held to window, because a missed cycle costs vision that does not return.
- Post-operative checks and drop regimens confirmed by phone rather than by clinic slot.
Retinal artery occlusion, acute angle-closure glaucoma, endophthalmitis after an injection, a retinal detachment with the curtain coming across. Each has a window measured in hours, and each usually opens with a caller saying something has gone wrong with their eye.
Primum runs the acuity questions that separate those from the conjunctivitis and the floaters people have had for years — sudden versus gradual, painful versus painless, one eye or both, flashes, curtains, halos, what changed today. Sight-threatening presentations route to emergency care immediately. The specialty's volume work, injection clinics and post-operative follow-up, is handled without clinic time.
Capabilities
The questions that separate an emergency from a nuisance
Ophthalmic triage is a small set of questions, asked in the right order, every time.
Injection clinics that hold interval
Anti-VEGF scheduling kept inside the treatment window, with post-injection symptom checks and an endophthalmitis threshold that treats pain and reduced vision after an injection as an emergency.
Post-operative follow-up by phone
Cataract day-one and week-one checks, drop regimen confirmation, and the red-flag questions that separate ordinary post-operative discomfort from an infection.
Drops actually instilled
Glaucoma adherence is the whole disease. Technique, timing, supply and tolerability checked, with escalation where pressure control depends on drops nobody is using.
How it works
From 'something's wrong with my eye' to the right door
Five questions decide almost every case.
- Arrives
- Decided
- Done
- Returned
01
Call opens
Patient matched with ocular history, recent surgery, injection schedule and current drops loaded.
Ocular history
02
Acuity established
Onset, laterality, pain, associated flashes, floaters or halos, and what the patient can actually see now compared with yesterday.
Acuity questions
03
Threat assessed
Findings evaluated against your sight-threatening criteria, with recent injection or surgery raising the threshold for concern automatically.
Sight-threat criteria
04
Routed or scheduled
Emergency eye service, urgent clinic, routine review or self-care — with the reasoning recorded and the patient told what to expect.
Routing + chart
01
Call opens
Patient matched with ocular history, recent surgery, injection schedule and current drops loaded.
Ocular history
02
Acuity established
Onset, laterality, pain, associated flashes, floaters or halos, and what the patient can actually see now compared with yesterday.
Acuity questions
03
Threat assessed
Findings evaluated against your sight-threatening criteria, with recent injection or surgery raising the threshold for concern automatically.
Sight-threat criteria
04
Routed or scheduled
Emergency eye service, urgent clinic, routine review or self-care — with the reasoning recorded and the patient told what to expect.
Routing + chart
Benefits
Sight saved at one end, capacity freed at the other
Ophthalmology has the highest ratio of routine contacts to genuine emergencies in medicine.
Emergencies reach the right door
Directing an artery occlusion to an emergency eye service rather than to a routine appointment is the difference between vision and no vision.
Injection intervals hold
Treatment windows missed by weeks produce irreversible loss. Scheduling that keeps the interval is a clinical intervention, not administration.
Clinics see the eyes that need examining
Post-operative checks and drop reviews handled by phone return slots to the patients who need a slit lamp.
In practice
Four eye calls in one morning
Two are emergencies. Both opened sounding routine.
Curtain across the vision
Emergency, 25sPainless, sudden, with flashes for two days. Retinal detachment pathway opens and the patient is sent to the emergency eye service immediately.
Day 3 after injection, aching
Endophthalmitis pathwayIncreasing pain with reduced vision after anti-VEGF. Treated as endophthalmitis until excluded and routed the same hour.
Red eye, itchy, both sides
Self-care adviceNo pain, no visual change, no photophobia. Conjunctivitis advice given with clear safety-netting and no clinic slot used.
Glaucoma drops, running out
Resolved on callSupply and technique checked, an instillation problem identified and corrected, and a repeat prescription issued.
Read next
- Emergency MedicinePost-discharge follow-up, results callbacks, ambulatory pathway coordination and the endless 'should I come in' calls — handled with emergency thresholds and an unambiguous bias toward being seen.Open
- Primary CareTriage, booking, refills, results, chronic disease reviews and recalls — the complete administrative and first-contact workload of a general practice, running on one layer.Open
- Appointment SchedulingBooking, rescheduling and cancellation handled end to end against your live diary — with the right appointment type, the right clinician, the right duration, and the preparation instructions sent before the caller hangs up.Open
Test it on the calls that sound routine
Every sight-threatening presentation opens as an ordinary complaint. Bring us the ones your service triaged last month and we will show you where the pathway fires.