Herpes keratitis has dendritic dye uptake and requires immediate treatment. Foreign bodies on the inner eyelid typically cause vertical linear corneal lesions therefore, everting the eyelids is necessary to assess for foreign bodies. If a patient wears contact lenses, the abrasion may have several punctate lesions that coalesce into a round, central defect. Traumatic corneal abrasions typically have linear or geographic shapes. The dye appears green under cobalt blue light. The fluorescein dye passes over normal cornea tissue but gets stuck in any cornea defects. Apply a drop of a topical anesthetic into the eye or on a fluorescein strip and then apply it to the conjunctiva. Document extraocular movements.įluorescein staining helps identify a corneal epithelial defect. Significant decreases in visual acuity require referral to an ophthalmologist. Abrasions over the center of the cornea will cause a decrease in visual acuity. The presence of hyphema or hypopyon requires an immediate ophthalmologic referral. Inspect the anterior chamber for hyphema or hypopyon. A hazy cornea is a sign of edema from excessive rubbing. The conjunctival injection is typically present. A corneal opacity or infiltrate may occur with corneal ulcers or infection. Topical anesthetics are helpful to facilitate the examination. An abnormally shaped pupil could be a sign of globe rupture.
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