Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 7 Sept 2026Clinical review pending
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Blur that needs an urgent diagnosis
Sudden visual loss, a painful red contact-lens eye, new retinal warning symptoms or neurological features should not be attributed to a spectacle prescription.
Action: Arrange urgent ophthalmic or emergency assessment according to the presentation. Remove contact lenses when infection is possible and do not restart wear while awaiting assessment.
Synopsis
Explain common refractive errors, connect their optical mechanisms with symptoms and select appropriate correction, monitoring or referral.
Myopia focuses distant light in front of the retina when accommodation is relaxed and is corrected with minus power.
Hypermetropia focuses light behind the retina without accommodation and is corrected with plus power.
Astigmatism involves different focusing powers in different meridians and usually needs cylindrical correction.
Key red flags
A myopic patient with new flashes, a shower of floaters or a field curtain needs urgent retinal examination.
Investigation priorities
01
Monocular distance and near acuityFirst step
Define the functional deficit before and after correction.
Management branches
CorrectProvide clear and comfortable everyday vision
Examination identifies a refractive error without an urgent alternative cause.
Explain the error and trial the required spherical, cylindrical or near addition with the person's usual tasks in mind.
Select spectacles or professionally fitted contact lenses according to optical needs, handling ability and ocular surface health.
Key medicines
Ryjunea 0.1 mg/mL atropine for childhood myopiaThis is a paediatric indication: in eligible children, instil one drop in each eye once daily, preferably at bedtime, under a myopia-competent prescriber.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.