Know when to go to ER, when to call a doctor, and when you can handle this yourself

House Calls runs monthly. Today's column is written by Doris Fitch, a registered nurse at Sutter Coast Hospital and trainer at College of the Redwoods.

Some eye injuries cause so much pain and abrupt changes in vision that going to the ER is a no-brainer. But other injuries may not be as obvious, even though they might still cause permanent damage or vision loss.

Most eye symptoms, whether caused by injury or something unknown, should be evaluated by a medical professional. It is difficult to determine which symptoms could result in a permanent loss of vision versus symptoms that will heal without difficulty.

The bottom line is that you are better off seeking medical attention whether you have acute or chronic symptoms. Changes in vision can be gradual or sudden; both will need to be evaluated by a medical professional.

For eye irritation due to an unknown cause, make an appointment with your eye doctor or care provider. Bloodshot eyes can be a very frightening symptom, but not always a serious condition.

The spot of blood that is visible at the surface of the eye is due to a condition called a subconjunctival hemorrhage. In this condition a small blood vessel leaks blood under the surface of the eye. It looks worse than it is and it will usually resolve on its own. Even so it is a good idea to see or call your physician.

On the other hand, bleeding into the eye itself is a medical emergency. Your eye will look like it is filled with blood. This is called a hyphema and requires immediate medical attention.

If a chemical gets into the eyes, immediately flush with tap water for 15 minutes to dilute the chemical and reduce further damage. If you wear contacts don't remove them before flushing. If the chemical is mild like soap, shampoo or sunscreen, it is not necessary to seek medical attention, although if the eye irritation continues you it might need to see your provider.

If you were exposed to a chemical that could cause severe eye irritation or chemical burn, or if the composition of the chemical is unknown, seek immediate attention.

The poison control phone number should always be readily available on the refrigerator door for quick access. Bring the solution that got in the eyes to your provider and let him or her know what emergency treatment you did and when the incident happened. It may be necessary to see an eye specialist.

If you have an injury to the eye or surrounding tissue due to trauma, such as lacerations, bruising or bone fractures, seek immediate medical attention. Injuries that would be considered minor elsewhere on the body are more severe when near the eyes.

If you experience sudden loss of vision due to sun exposure or exposure to ultraviolet light you will need medical attention. This can cause retina damage, and more than likely the ER will not be able to help you. Make an appointment to see your ophthalmologist so he or she can evaluate the extent of injury and treatment options.

If you have a foreign object in your eye you may gently rinse it out with water. If this does not work, seek medical attention. Large embedded objects require immediate attention by an emergency provider. Do not try to remove the object, instead call 911 and stay calm. Any object that is in your eye will require medical attention.

Pain can be relieved by anophthalmic lidocaine solution the emergency provider may place in your eye. Rubbing your eye can scratch the chorea so keep your hands off of them.

A clean Kleenex is a good choice, and allow your natural tears to cleanse your eye. Eyes are very delicate - never apply pressure to stop bleeding.

If you have an eye injury and you have contacts, do not try to remove them. Let the emergency providers know you have them in your eyes.

Anytime you have any doubts about a minor injury it is a good idea to at least call an ophthalmologist and ask if the injury is serious enough to come for an office visit.

Strokes can cause visual changes. Sudden black spots are common. High blood pressure can cause headaches and visual disturbances. High blood sugars can cause blurred vision too. All of the conditions mentioned above will need emergency medical attention.