Check VA (important even if pain and swollen lids make that difficult)
Topical anaesthetic (to aid examination)
Protect eye by taping over it a rigid plastic shield
Advice
Advise patient not to touch the eye and try not to cough or strain
Advise patient to take nil by mouth
To assist swallowing of tablets, a small amount of water is permissible
Management Category
Immediate referral
Possible management by Ophthalmologist
Surgical management of penetrating injury
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The eyes.nhs.scot website (“Website”) is intended as a reference source for education and clinical
decision support and is intended for use by ophthalmic healthcare professionals.
The Website is not intended for use by the general public and does not replace the advice of a healthcare professional.
Members of the public should seek advice directly from their optometrist.
The guidelines on the Website were originally adapted from The College of Optometrists’ Clinical Management Guidelines
(CMGs), to incorporate pragmatic experience gained from NHS Grampian’s Eye Health Network. However, this content is currently under review.
The most up-to-date versions of The College of Optometrists’ CMGs can be accessed
at https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines.
The information on the Website provides guidance and related information for the differential diagnosis, possible
management by optometrists (treatment and advice), management category and possible management by ophthalmologists.
Users should note that that the guidance on the Website will not be suitable for every situation and is not intended to be a
substitute for specialist expertise and clinical judgement. Users should also note that this guidance should not be adhered to
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