This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages without signing in

GEM - eye problems including red eye, floaters and diplopia

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • Eye problems are common - around two million people in the UK have a sight problem
  • Eye problems account for 1.5% of general practice consultations in the UK with a rate of 50 consultations per 1000 population per year
  • Eye problems are significant causes of preventable disabilities
  • The general practitioner has a key role as part of the primary health care team in the prevention and treatment of eye problems...(1)"

Red eye

The patient with a with a red eye is common presentation in general practice. What features help distinguish between acute glaucoma, iritis and conjunctivitis?

If bacterial conjunctivitis is suspected then

  • what are the clinical features of bacterial conjunctivitis?
  • topical antibiotic treatment is beneficial in culture positive bacterial conjunctivitis. What about the likely benefit if empirical treatment of suspected bacterial conjunctivitis?
  • if topical treatment is administered using chloramphenicol, is there a significant association between agranulocytosis and use of chloramphenical topically?

Floaters and Flashes

How should the primary care clinician manage referral for the patient presenting with floaters and flashes?

The possible causes of floaters and flashes is considered

  • GPN reference A possible cause of a presentation with a history of floaters and flashes is retinal detachment.
    • what is retinal detachment?
    • what are the factors are associated with a higher incidence of retinal detachment?
    • the clinical features of retinal detachment are summarised


What causes should be considered when a patient presents with a history of gradual onset bilateral loss of vision?

  • GPN referenceA possible cause of gradual loss of vision is macular degeneration
    • what are the clinical features of early macular degeneration?
    • with respect to treatment
      • is laser therapy of benefit for exudative ('wet') or non-exudative ('dry') macular degeneration?
      • is there any evidence of benefit for the use of dietary measures?


  • what is diplopia?
  • what is monocular diplopia?
  • when considering binocular diplopia
    • what is binocular diplopia?
    • what are examples of muscular causes of binocular diplopia?
    • what are some examples of neurogenic causes of binocular diplopia?
    • with respect to specific examination of the diplopia, what features should be considered?
    • what is the guidance regarding driving and diplopia?


  1. Royal College of General Practitioners. Curriculum Statement 15.5 Eye problems.

Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.