This guideline last updated 06/05/2022 17:53:31

Differential diagnosis

• Corneal abrasion
• Other causes of acute red eye; history should aid the diagnosis

Possible management by Optometrist

Treatment

• Copious prolonged irrigation of the eyes with sterile normal saline or, if not immediately available, tap water
• Irrigate for 30 minutes (with intermittent topical anaesthetic if required) or until pH between 7 and 8
  • To measure, cease irrigation, wait for 1 minute, apply universal indicator paper to fornix
  • When pH normal stop irrigation and re-check after additional 30 minutes
• Remove any particulate matter
• Give ocular lubricants for symptomatic relief
  • Manage as abrasion if epithelial loss
    • Ask if allergic to Chloramphenicol
    • If not, supply Chloramphenicol 1% eye ointment 3 times daily for 5 days
    • If allergic to Chloramphenicol, or pregnant, supply Fucidic acid 1% liquid gel twice a day for 5 days
• For pain or photophobia, advise systemic analgesia and darkened room

Advice

• Contact lens solution accidents do not require irrigation, but advise no contact lens wear until after satisfactory review

Management Category

• Severe cases require immediate referral
  • Any strong alkali or acid burn
  • Limbal ischaemia
  • Loss of corneal transparency
• Mild cases: normally no referral

Possible management by Ophthalmologist

• Further irrigation
• Admission to hospital where necessary
• Topical and oral treatment
• Surgical rehabilitation