Synopsis
Examine the anterior segment with appropriate illumination, interpret corneal fluorescein findings and recognise circumstances in which irrigation or urgent referral takes priority.
- Check the mechanism, contact lens use and visual symptoms before putting drops into a red or injured eye.
- Irrigate a chemical exposure immediately; history taking, acuity measurement and finding a slit lamp must not delay washing the eye.
- Inspect the cornea in white light before fluorescein because staining alone does not show every infiltrate or deeper abnormality.
Key red flags
A high-velocity injury, abnormal pupil or apparent full-thickness wound needs emergency ophthalmology without pressure on the eye, tonometry or attempts to remove a protruding object.
Investigation priorities
Identify opacity, pupil distortion and deeper warning findings before dye obscures detail.
Management branches
A stable patient has ocular irritation or suspected superficial corneal damage.
- Establish visual function and injury or contact lens history, then inspect the anterior segment with white light.
- Use appropriate fluorescein staining and slit-lamp illumination to document epithelial pattern, opacity, location and chamber findings.
Key medicines
Minims fluorescein sodium 1% eye dropsApply topically to the eye during the diagnostic examination, drop by drop only until adequate staining is obtained; remove excess with sterile saline if necessary. This is a single examination exposure, and the opened unit must be discarded.