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hx
VAs
look at cornea
anesthetic
NaFl
r/o chance of penetrating injury
assess amount of blunt force trauma/posterior pole risks/IOP effects
rinse & remove any foreign matter
cycloplege w/ 5% homatropine
discuss tx options (BCL, topical antibiotic, topical pain meds)
what are the steps to an abrasion anaysis?
protect against infection
promote corneal healing
promote pt comfort
maintain surface hydration
what are the goals of abrasion therapy?
patch basically incubates any infection that is present underneath
eye is not visible so pt cannot monitor
pt usually just removes patch once out of office
can be uncomfortable
cannot give any topical pain relief
why is pressure patching not very good?
can instill antibiotic drops as often as needed
can use an antibiotic ung at night
still have tear circulation & rinsing
eye is visible so pt can monitor
pt can monitor vision changes
lens keeps lid away from healing epithelium
more oxygen is allowed to the cornea
pt comfort is better
can instill topical pain meds PRN
better cosmetically
why is a BCL preferable over pressure patching?
50
as many as ___% of pressure patched eyes removed their patch before their next appt
EW
minimally, a BCL needs to be an ____ approved lens
moderately tight SiHy EW
what is the best BCL fit/type?
CIBA night & day, Purevision & Purevision 2, Acuvue Oasys
what are some FDA approved BCLs/
CIBA night & day & Oasys
what are usually the best BCLs?
fluoroquinolones QID
what is typically the best antibiotic type & dosage for an abrasion?
T
T/F: you can Rx antibiotic ung at bedtime for the pt if the risk of infection for an abrasion is deemed high
OTC (aspirin, tylenol, ibuprofen, naproxen), Ultram
what are some systemic pain relievers given for an abrasion?
Acular, Voltaren, QID
what are some topical pain relievers given for an abrasion & what dosage are they approved for?
recurrent corneal erosions
severe dry eye or ocular surface disease
what are some other uses for BCLs besides erosions?