Wednesday, January 30, 2008

Vol 2:4 Answer

The Question
The answer is c.
The patient most likely sustained a corneal abrasion from prolonged contact lens use. Epithelial defects of the cornea are diagnosed by slit lamp exam by observing fluorescein uptake in the area of the defect. Treatment usually consists of cycloplegia, and topical or oral pain medications. Contact lens patients should be treated with topical antibiotics with antipseudomonal coverage. Patients should not wear their contact lens until complete healing of the corneal epithelium. All patients should follow-up with an ophthalmologist.

(a) Corneal abrasions usually heal well with appropriate care and do not require a transplant. (d) Amoxicillin is not an appropriate antibiotic because it is not topical and not anti-pseudomonal. In addition, tetracaine, if used frequently, can decompose the cornea and cause permanent damage. (e) Eye patching should be avoided, particularly with injuries involving contact lens. Data suggest that eye patching confers no benefit in healing small, uncomplicated corneal abrasions and may provide a better environment for pseudomonas to proliferate.

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quizzER is a weekly contest consisting of a question selected from various areas of emergency medicine that are central to the education of medical students and residents in training. For more information please refer to the following link.

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