This guideline last updated 07/05/2022 9:30:53

Differential diagnosis

• Acute viral keratoconjunctivitis
• Contact or toxic keratitis
• Contact lens over wear
• Dry eye
• Foreign body

Possible management by Optometrist

Treatment

• Ocular lubricants for symptomatic relief (drops for use during the day, unmedicated ointment for use at bedtime)
• Antibiotic as prophylaxis against infection, if risk high
  • 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
• Cyclopentolate 1% 3 times daily until pain free
• Oral analgesic for pain relief

Advice

• Reassure patient that damage is transitory and pain will be gone within 24 to 48 hours
• Mild photophobia and blurring may persist for a week or longer
• Sunglasses to ease photophobia
• Review following day (corneal epithelium should have largely healed)
• Advise patient to return/seek further help if symptoms persist
• Advise patient on future eye protection

Management Category

• Management to resolution by Optometrist

Possible management by Ophthalmologist

• Not normally required