Red eye (Guidelines)

Symptoms:

Pain and photophobia, watering, decreased vision

Signs:

Corneal epithelial disturbance (but no corneal opacity) which stains well with fluorescein, red conjunctiva

Management:

• Chloramphenicol ointment 4 times daily for 5 days
• Oral analgesia as required
• Other Analgesia if required: Consider Topical Cyclopentolate 1% stat and Topical Diclofenac pack to take home
• Discharge

Symptoms:

• Few hours after welding (or sunbed use)
• Pain and photophobia, watering, decreased vision

Signs:

Red conjunctiva, mild corneal haze, diffuse punctuate corneal staining with fluorescein

Management:

• Chloramphenicol ointment 4 times daily for 5 days
• Analgesia: Topical Cyclopentolate 1% stat then Topical Diclofenac pack to take home
• Oral analgesia as required
• Discharge

Symptoms:

Itching, burning, gritty, watery or discharging eyes

Signs:

Red and oedematous lids and conjunctiva, discharge on lashes

Management:

• Conjunctival swab if possible
• Chloramphenicol ointment 4 times daily for 5 days
• Liquifilm tears 4 times daily for lubrication if required
• Oral analgesia as required
• Discharge

Symptoms:

Increasing pain and especially photophobia, decreasing vision

Signs:

• Red conjunctiva - especially adjacent to corneal limbus
• Check cornea is normal (including with fluorescein) to exclude a corneal ulcer

Management:

• Predforte or Maxidex hourly during day
• Cyclopentolate 1% 3 times daily
• Oral analgesia as required
• Ophthalmology review in clinic within 3 days – refer by email

Symptoms:

If no trauma involved usually asymptomatic, sometimes foreign body sensation

Signs:

Blood under conjunctiva obscuring underlying sclera

Management:

• Liquifilm tears 4 times daily for lubrication if required
• Discharge