AOA 2026: How to approach ocular emergencies and urgencies

In his AOA Optometry’s Meeting 2026 presentation “So What Had Happened Was...Ocular Emergencies and Urgencies,” Mark Schaeffer, OD, FAAO, discussed the central role of optometrists in recognizing, triaging, and managing ocular emergencies, emphasizing that confidence in diagnosis and management is essential. Ocular emergencies are presented as a heterogeneous group of conditions, some of which can be treated directly in the optometric setting—often anterior segment problems—while others require prompt referral to specialists with appropriate surgical or medical capabilities. Schaeffer underscored that effective care is not limited to identifying pathology; it also involves navigating patients to the right destination, whether that is a primary care physician, a retina surgeon, an emergency department, or another specialist.

A key theme is that the pattern of emergencies is inherently variable and cyclical. There may be long stretches with no true emergencies, followed by weeks where multiple urgent cases present. This variability reinforces the need for constant readiness and a mindset that rare conditions are only “rare” until they appear in one’s own exam chair—summarized by the adage, “it’s not rare if it’s in your chair.” Schaeffer argued that this perspective helps clinicians remain vigilant and prepared to manage unusual or high-stakes presentations.

Another major point is patient education and pathway optimization. The speaker advocates strongly for patients to view their optometrist as the first point of contact for eye-related symptoms such as redness, photophobia, vision changes, or ocular pain, rather than defaulting to urgent care clinics or general “doc in the box” services. Because optometrists have specialized training in eye disease, they can more quickly determine the correct course—initiating treatment, coordinating referrals, or engaging other medical providers as needed.

Finally, the concept of scope expansion is framed as both an opportunity and a responsibility. Expanded scope allows optometrists to manage a broader range of conditions and intervene earlier, but does not remove the need for multidisciplinary collaboration. Many patients still require coordinated care involving multiple doctors, especially when ocular findings point to systemic issues such as stroke, uncontrolled hypertension, or other vascular events. Overall, Schaeffer highlighted optometrists’ pivotal role in safeguarding vision through timely, informed, and collaborative management of ocular emergencies.