Date of last review: Due to be updated
Differential diagnosis
- Other causes of acute red eye
- Pre-septal cellulitis
Possible management by Optometrist
Treatment
- Cold compress to ease lid oedema
- Refer to local Pharmacist for analgesia for pain relief (Paracetamol or Ibuprofen; dose depends on age)
- Topical antibiotic and ocular lubrication for any corneal abrasion
- 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 Fusidic acid 1% liquid gel twice a day for 5 days
Advice
- Dependent on clinical findings
- Advise patient to return/seek further help if symptoms persist
Management Category
- Ocular management depends on mechanism and severity of injury
- Initial referral to A&E may be more appropriate if there has been a period of unconsciousness or if there is suspicion of skull or orbital fracture
- Severe cases (usually with some loss of visual function) should be referred same day if:
- Enophthalmos
- Nasal bleeding
- Relative afferent pupillary defect
- Traumatic mydriasis
- Disturbance of ocular motility
- Infraorbital nerve anaesthesia
- Corneal oedema or laceration
- Hyphaema
- Iridodialysis
- Lens subluxation
- Raised IOP
- Vitreous haemorrhage
- Commotio retinae
- Retinal detachment
- Retinal dialysis
- Traumatic macular hole
- Globe rupture
- Mild cases (usually with good corrected vision) not normally referred
- Eyelid oedema
- Eyelid ecchymosis
- Conjunctival chemosis
- Subconjunctival haemorrhage
- Corneal abrasion
Possible management by Ophthalmologist
- Assessment and investigation
- Treatment of globe rupture where present
- May require hospital admission