This guideline last updated 06/05/2022 17:51:24

Differential diagnosis

• Scleritis
• Conjunctivitis
• Phlyctenular keratoconjunctivitis
• Anterior uveitis

Possible management by Optometrist

Treatment

• Cold compresses
• Artificial tears as necessary for 1-2 weeks
• PoM If particularly symptomatic but no signs to suggest scleritis:
  • Prednisolone 0.5% 4x daily (reduce by 1 drop a week to zero)
  • or Fluorometholone 0.1% eye drops 4x daily (reduce by 1 drop a week to zero)
• Refer to local Pharmacist for non-steroidal analgesia for pain relief (Ibuprofen; dose depends on age)

Advice

• Usually self-limiting in 7-10 days
• Reassurance: condition does not generally progress to more serious ocular disorder
• Patient to return/seek further help if symptoms persist

Management Category

• Management to resolution
• Refer to ophthalmology if
• Pain on eye movement
• Scleral tenderness
• Deeper vessel involvement (redness remains despite Phenylephrine 1%)
• If underlying systemic disease suspected

Possible management by Ophthalmologist

• Topical steroid
• Investigation, guided by symptoms and signs