When I'm on the night shift, all the department heads can't sleep.

Nurse Zhao glanced at the man in the plaid shirt sitting on the examination chair and opened the emergency room registration form: "Name, age, do you have your ID?"

"Zhou Qiming, 26 years old, I brought my ID card, it's behind my phone case."

Zhou Qiming blinked twice, his hand rubbing his eyes freezing in mid-air. "Huh? Is this considered an emergency? Don't delay your treatment. Should I register again tomorrow morning?"

Lin Ye pulled up the plastic chair next to him and sat down opposite him, gently pressing down on his hand that was rubbing his eyes: "Stop rubbing. Eyes aren't only seen during the day at the clinic. In your current condition, you can't wait until tomorrow for an examination."

"Tell me the details again."

Zhou Qiming thought for a moment, then tapped his phone screen to check the time: "It's probably around 10:40, right? I was revising the last draft when I looked up and rubbed my eyes and noticed it. At first, I thought it was just my eyes getting blurry from staring at the screen for too long, but it's been almost forty minutes and it's still there."

"Has the location changed? Will it follow your eyeballs?"

"It hasn't changed. It's just in the area below my left eye's field of vision. When it blocks my view, the text is always half a line short. It follows my eye wherever I move. It's not one of those floating mosquitoes."

"Do your eyes hurt? How about your head? Do you have a headache or feel nauseous?"

Zhou Qiming blinked and shook his head: "It doesn't hurt, it's just a little dry from staying up too long, but I don't feel dizzy or have a headache, and I don't feel nauseous."

Have you recently experienced slurred speech, a crooked mouth, or numbness and weakness in your hands and feet? Raise both arms straight out to the side and point your toes upwards.

Zhou Qiming did as instructed: "No, I just rode my electric bike here, and the handlebars were fine."

After he finished speaking, he tried to rub his left eye again, but Lin Ye gently blocked his hand with the pen.

"Put your hands down first, the more you rub, the less you can see."

When Lin Ye blocked his hand, a light blue notification box flashed before his eyes.

Emergency Room Early Warning System

[Risk Area: Increased risk of ophthalmic emergencies.]

[Abnormality: Sudden loss of visual field in one eye, no obvious eye pain, and no relief after rubbing the eye.]

[Key gaps: accurate onset time, extent of visual field defect, degree of myopia, changes in flashes of light/floaters, and accompanying neurological symptoms.]

He first circled the time of the attack, and then added a dot next to each of the words "single eye", "painless", and "fixed shadow".

"Have you had a physical examination before? Do you have high blood pressure, diabetes, or atrial fibrillation? Do you usually take aspirin or anticoagulants?"

"Last year's physical exam showed that my blood pressure was a little high, over 140. I'm young, so I didn't take it seriously. I didn't take any medication, and I didn't check my blood sugar much. The doctor never mentioned atrial fibrillation, and I didn't take aspirin or anticoagulants."

"Have you bumped your eye recently? Have you coughed violently or lifted heavy objects?"

Zhou Qiming paused for a moment, then suddenly remembered: "Oh right, yesterday the company moved to a new printing press. I carried two boxes of A4 paper up to the third floor. I held my breath for a moment, and felt a little dizzy after I got up there, but I felt fine after a couple of minutes. I didn't do anything else strenuous."

"Do you wear contact lenses? Have you used any eye drops or taken any special medications recently?"

"I wear glasses and haven't used any eye drops. I've been drinking iced Americano every day lately because I'm working overtime, and I haven't taken any other medications."

"How nearsighted are you? Did you experience any flashes of light or that feeling like a curtain was drawn down just now?"

"Over 600 degrees." Zhou Qiming adjusted his glasses, his voice a little softer than before. "There doesn't seem to be any flash, and it doesn't seem to be blocked like a curtain, but there's a gap at the bottom. When I was looking at text on my phone earlier, the bottom half of the line was always missing a section."

Ma Hao was lying by the triage desk filling out surgical records when he heard Lin Ye ask about the crooked mouth and weak limbs. He muttered to himself, "This time I'll write down all the bowel sounds and incision oozing. Let's see if Old Wang still finds fault."

Qin Hai and Nurse Zhao walked over from the observation area. As they passed by the child's bedside, they casually lifted the blanket and gently pressed the child's stomach. The child whimpered and turned over, signaling to the parents standing by the bedside not to rush.

Reaching the triage desk, Qin Hai picked up the eye shield, quickly checked his vision, and then asked to confirm, "The dark shadow is fixed in one place, right? It's not flying around?"

"Yes, I've had those fixed, floating floaters before, but not like this." Zhou Qiming's voice lowered. "Doctor... is it anything serious? I really thought it was just eye strain."

"Don't scare yourself. Stay seated." Qin Hai handed the eye shield to Lin Ye and turned to Nurse Zhao, saying, "Call the ophthalmology department for an emergency consultation. A 26-year-old male has suddenly experienced a painless, fixed visual field defect in one eye for forty minutes. He has a history of high blood pressure and had to lift heavy objects the day before the onset of the illness. Please ask him to come down and take a look as soon as possible."

After he finished speaking, he added, "Also, let the neurology department know. Call me anytime if there are any accompanying symptoms. The child with the magnetic beads is due for a follow-up scan soon; call me when the images are ready."

Nurse Zhao had already handed him the phone receiver; the internal line had been dialed beforehand. Lin Ye took it and held it to his ear, waiting for two rings before a muffled male voice came from the other end.

"Is there an ophthalmology shift? There's a patient in the emergency room who suddenly felt a missing patch in the lower left field of vision around 10:40. The dark shadow is fixed and doesn't move, and rubbing it doesn't help. There's no obvious eye pain, headache, or nausea right now. He's nearsighted, with over 600 degrees of myopia."

The person on the other end of the phone was initially a little unclear, but after hearing the symptoms, there was a half-second of silence.

"Is there any flash of light? Is there any curtain-like obstruction? Has the number of floaters suddenly increased?"

"He said the flashes weren't obvious, there was no obvious curtain-like obstruction, and the number of floaters didn't suddenly increase; it's just that there's a gap at the bottom. I just did a quick check of his hands and feet and didn't find anything abnormal for the time being. He has a history of high blood pressure, no definite atrial fibrillation, and isn't taking anticoagulants."

There was a rustling sound coming from over there, as if someone had sat up from the duty bed.

"Don't go, I'm coming down right away."

A few minutes later, the elevator door at the end of the corridor dinged.

The ophthalmologist on duty strode out, holding a small flashlight, and looked at Zhou Qiming on the examination chair.

"Sudden dark shadow in one eye? Left eye?"

Lin Ye handed over the notebook: "Zhou Qiming, 26 years old, started feeling unwell around 10:40, has a fixed visual field obstruction in his left eye, is over 600 degrees nearsighted, has no obvious eye pain, headache or nausea, and I just did a quick check of his hands and feet and found nothing unusual."

The ophthalmologist took the notebook, glanced at it, and said, "Come with me to the ophthalmology examination room first. There's equipment in the duty room that can examine the fundus. Don't look at your phone on the way."