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Posted: January 18th, 2023
Week 2 Discussion
Eye Conditions
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AM is a 22-year-old man presenting to the local emergency department (ED) with acute onset
of right eye pain. The pain started 6 hours prior and has not improved with artificial tears or oral
acetaminophen. He reports the possibility of accidentally “scratching his right eye” when trying
to remove his contact lens.
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Past Medical History
• Wears soft contact lenses, replaces monthly
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• Denies swimming or showering in contacts
• Occasionally sleeps in contacts
Physical Examination
• Visual acuity: right eye, 20/40; left eye, 20/20
• Right eye is diffusely injected, small pinpoint area of haze is noted in the periphery at 6 o’clock; region subsequently stains with fluorescein
Discussion Questions
1. What is the appropriate pharmacologic treatment for AM?
2. What is the appropriate follow up for AM?
3. How should AM be counseled regarding his contact lens
2. A minimum of 2 paragraphs is required
3. Support all posts with at least 2 cited peer review references within 5 years of publication (references cannot be older than 5 years).
4. All posts are to be written in APA 7th edition format as required by the university
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The appropriate pharmacologic treatment for AM would be to administer a topical antibiotic such as moxifloxacin or ciprofloxacin. These antibiotics are commonly used to treat bacterial infections of the eye, such as corneal ulcers, which can occur as a complication of contact lens wear. It is also important to administer a topical steroid such as prednisolone acetate to decrease inflammation and prevent the formation of scar tissue. Additionally, oral analgesics such as ibuprofen can be administered to alleviate pain.
The appropriate follow-up for AM would be to schedule a follow-up visit with an ophthalmologist within 24-48 hours after the initial ED visit. The ophthalmologist should perform a thorough examination of the eye, including a visual acuity test, a slit-lamp examination, and a culture of the corneal ulcer if one is present. The ophthalmologist should also discuss the results of the examination and the treatment plan with the patient. Follow-up visits should be scheduled as needed to monitor the patient's progress and to ensure that the infection has been fully resolved.
AM should be counseled regarding his contact lens usage and the risks associated with it. He should be advised to remove his contact lenses before going to bed and not to sleep in them. He should also be advised to avoid showering or swimming while wearing his contact lenses. AM should also be advised to replace his contact lenses monthly or as recommended by the ophthalmologist. He should also be advised to clean and disinfect his contact lenses properly according to the manufacturer's instructions. Additionally, AM should be advised to seek medical attention immediately if he experiences any discomfort or redness while wearing his contact lenses.
References:
American Academy of Ophthalmology. (2019). Corneal ulcer. Retrieved from https://www.aao.org/eye-health/diseases/corneal-ulcer
American Academy of Ophthalmology. (2019). Contact lens complications. Retrieved from https://www.aao.org/eye-health/
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