Eye Pain and Visual
Change
Questions
444.A 24-year-old woman presents to the emergency department (ED)
complaining of right eye pain and blurry vision since waking up this morn-
ing. She states that the pain began after taking out contact lenses that were
in her eyes for over 1 week. Her blood pressure (BP) is 120/75 mm Hg,
heart rate (HR) is 75 beats per minute, temperature is 99.1°F, and respira-
tory rate (RR) is 16 breaths per minute. Her right and left eye visual acuity
is 20/60 and 20/20, respectively. Her conjunctivae are injected. The slit-
lamp examination reveals a large area of fluorescein uptake over the visual
axis. Which of the following is the most appropriate therapy?
a. Call the ophthalmology consult for an emergent corneal transplant.
b. Prescribe a systemic analgesic for pain control and advise the patient to not wear
her contact lenses for the next week.
c. Prescribe ciprofloxacin eye drops, oral analgesia, update tetanus prophylaxis, and
arrange for ophthalmology follow-up.
d. Prescribe oral amoxicillin, a topical anesthetic, such as tetracaine and have patient
follow-up with an ophthalmologist.
e. Prescribe ciprofloxacin eye drops and have patient strictly wear an eye patch until
her pain resolves.
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