The College of Optometrists

If i suspect a px with viral conjunctivitis eg Adenovirus which is not affecting vision, mild/moderate discomfort and no corneal involvement, How should i managed this practice?? In addition to advising removing cause - e.g CLs, Lid hygiene should i

a) Refer to GP for anti-viral (Acyclovir)and/or prophylaxis anti- bacterial drops?? and monitor

b) Refer to Opthalmologist

I have just had adenovirus Honey,

There is no treatment - just rest -you feel aweful anyway. I had a huge gland infront of my ear - like a gobstopper - quite sore it ws as well! My eyes were puffy and weapy and bleared from infiltrates in the cornea.

They suggest comfort eye drops - but there is little to do but wait it out adn avoid spreading it. You can't manage it in practice other than no contact lenses and refer them to doctor - but then if you are sure of your diagnosis - why refer them to gp - it would only spread the virus all the more! So just a note informing doctor in that case

(I got no sympathy from my family :-{

so for exam purposes if id have said that i was confident that the patient i had seen in my practice had adenoviral keratitis with a little drop in VA and that i would manage the Px by notifying the GP, would that stand? or would the examiners feel that i was unfit to practice due to my management route? because some examiners feel at this stage we are still learning ie gaining experiance therefore wouldnt it be safe to refer to HES? (jus for exam point of view?)

If the eye sore and VA reduced then some ophthalmologists will treat the inflammation with topical c/steroids. Probably doesnt shorten infection but helps with symptoms. Therefore a referral via GP is probably best.

if this is a case record - I would probably void presenting it. Nice to have something interesting but could hang yourself. Present what you commonly see.

Some ophthalmologists would avoid this like plague!

its not a case record but one of my friends got asked how he would manage this at bradford for ODA. There are so many different opinons but i was trying to establish which one would be thought of as safe to practice and my best answer procedes to say that i would ring the duty ophthalmologist on the day and procede from there

If you suspect this, then what are your reasons. If indicative, phone duty ophthalmologist. What if eye dept is 50 miles away?

well my HES is only a 5 min walk away :)

sorry to disappoint but your nearest dept is 50 miles away - so wipe the smile off your face and tell me what you'll do now?

well why couldnt i ask the duty ophthalmologist even if the HES is 50 miles away? that dont mean they dont have a telephone service - does it? If it was such a situation then i would prefer to have his opinion, and if he expressed his opinion to refer to the Gp then i would do so