This guideline last updated 06/05/2022 17:49:27

Differential diagnosis

• Dendritic ulcer
• Corneal abrasion (e.g. from contact lens)
• Superficial punctate keratopathy of another cause

Possible management by Optometrist

Treatment

• Topical local anaesthetic to aid examination and removal of foreign body
• Evert upper eyelid (may require double eversion)
• Sweep the fornix with saline-wetted cotton bud
• Prescribe tear supplements/ lubricants for symptomatic relief
• Consider prophylactic antibiotic if there is substantial epithelial loss or foreign matter contamination of the conjunctival sac
  • 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

Advice

• Advise on future suitable eye protection
• Advise patient to return/seek further help if symptoms persist

Management Category

• Normally no referral

Possible management by Ophthalmologist

• As above