Post-operative problems (Guidelines)

Have a low threshold for contacting the on-call Ophthalmologist for all patients presenting from 08.00-20.00 who are within 2 weeks of an operation or injection

• not common
• 1 to 14 days after operation or injection
• moderate to severe eye pain not helped by proxymetacaine drops
• marked visual loss (usually 6/24 or worse)
• Hypopyon
• Emergency: see separate “Endophthalmitis” section for management

• common
• within hours of operation
• discomfort and decreased visual acuity (variable)
• no hypopyon
• some generalised corneal fluorescein uptake or frank corneal abrasion
• discomfort immediately settles with topical local anaesthetic, eg, proxymetacaine
• Management: Chloramphenicol ointment and reassurance

• common
• within days or weeks of operation
• discomfort and mildly decreased visual acuity
• if only mild conjunctival redness, and no hypopyon, then have excluded endophthalmitis
• Management: review the following day in the Ophthalmology unit

• not common
• if only mild conjunctival redness, and no hypopyon, then check intraocular pressure (IOP) with tonometer (A&E Raigmore)
• if raised (over 30) or can’t check pressure, consider start topical glaucoma medication as per Acute Angle Closure Glaucoma protocol (Latanoprost, Timoptol and Iopidine) and arrange review following day in Ophthalmology Unit