Date of last review: Due to be updated

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