This guideline last updated 17/06/2022 14:21:16

Differential diagnosis  

• Corneal infiltrative lesions
• Acanthamoeba keratitis

Possible management by Optometrist

Treatment

• None, unless rapid access to ophthalmology impossible or advised by ophthalmology
• PoM Ofloxacin 0.3% hourly, titrate as per response, minimum final frequency 4 times a day
• Cyclopentolate 1% three times a day for one week, if in pain

Advice

• Warn contact lens wearers not to discard their lenses or lens cases, but to retain them for culture
• Emergency referral to an ophthalmologist

Management Category

• Emergency referral to an ophthalmologist

Possible management by Ophthalmologist

• Corneal scraping for microscopy, culture and antimicrobial sensitivity
• Intensive topical anti-bacterial therapy