Other causes of corneal oedema including Fuchs' dystrophy and infective keratitis
Possible management by Optometrist
Treatment
Cease contact lens wear
Topical lubricants for symptomatic relief
Consider prophylactic topical antibiotic if epithelial surface acutely disturbed by oedema and if secondary infection seems likely to occur
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
Cyclopentolate 1% 3 times daily until healed
Consider padding eye to alleviate symptoms
Avoid bandage contact lens (hypoxia may induce corneal vascularisation)
Reassess corneal topography on resolution (often less steep after hydrops)
Advice
Reassure patient that condition will resolve and may not ultimately affect visual function
Review weekly for appearance of vascularisation or other complication
Majority of cases resolve over 2-4 months
May leave some stromal scarring
Management Category
Normally no referral
Urgent referral if vascularisation present
Possible management by Ophthalmologist
As above
Topical steroid
Penetrating keratoplasty
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