This guideline last updated 06/05/2022 17:46:20

Differential diagnosis

• Seasonal allergic conjunctivitis
• Chemical trauma
• Preseptal cellulitis
• Orbital cellulitis

Possible management by Optometrist

Treatment

• Cold compresses for symptomatic relief usually sufficient
• For acute relief consider PoM topical antihistamine
  • PoM Olopatadine 1 drop twice daily (8 hourly interval) whilst symptomatic
    • Contraindicated in
      • breastfeeding/pregnancy
      • women of childbearing age not using contraception
      • Caution in dry eye/compromised ocular surface if prolonged use planned
• If recurrent, consider prophylactic use of sodium cromoglicate 2% eye drops 4 times daily

Advice

• Usually caused by air borne allergen(s)
• Self-resolving within a few hours
• Advise avoidance of allergen(s)
• Discharge patient with offer to review if symptoms do not improve

Management Category

• Normally no referral
• If associated hay fever / asthma / eczema, discuss referral to GP or pharmacist for an oral antihistamine
• Refer to ophthalmology if
  • Corneal epithelial defect
  • Corneal stromal infiltrate

Possible management by Ophthalmologist

• Not normally referred