{"id":3823,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/cornealulcer-contactlenskeratitis\/"},"modified":"2026-01-28T14:28:38","modified_gmt":"2026-01-28T14:28:38","slug":"cornealulcer-contactlenskeratitis","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/ophthalmology\/painfulredeye\/cornealulcer-contactlenskeratitis\/","title":{"rendered":"Corneal Ulcer &#8211; Contact Lens Keratitis"},"content":{"rendered":"\n<p>\u200b<span>Patients with\nsuspected ulcers or contact lens keratitis should be referred to ophthalmology\nfor further management and investigations<\/span><\/p>\n\n\n\n<p><span>Always have a high\nlevel of suspicion in patients who wear contact lenses if they present with a\npainful red eye. Consider keratitis even if they have had an injury suggesting\nabrasion\/foreign body. They require examination under slit lamp by an experienced\noptometrist\/ophthalmologist to rule out contact lens keratitis. This tends to\nbe a small circular lesion which stains with <span><span>fluorescein.\n<\/span><\/span><\/span><\/p>\n\n\n\n<p><span>Recommendations to\ncontact lens wearers include washing hands prior to inserting lenses. Having\ncontact lens free days each week and ensuring lenses are not worn for longer\nthan 8-10 hours a day are important to prevent corneal hypoxia. Avoid swimming\nand showering in contact lenses as these increase the risk of acanthamoeba\ninfection. Prescription goggles\/sunglasses at a reasonable price are available\nonline\/from high street optometrists. <\/span><\/p>\n\n\n\n<p><span>Patients with these\nconditions will present with a painful red eye, gritty sensation and\nphotophobia. If pain is severe and out of proportion to what is seen with\nfluorescein staining acanthamoeba should be considered. <\/span><\/p>\n\n\n\n<p><span><span>If a contact\nlens wearer develops conjunctivitis they should avoid lenses until this\ncompletely clears up as this increases the risk of a secondary keratitis. <\/span><\/span><\/p>\n\n\n\n<p><span><span>Following\ntreatment for a contact lens related infection lenses should not be resumed\nuntil follow up with an optometrist. They may advise different lenses and less\nfrequent use.<\/span><\/span><\/p>\n\n\n\n<p><span>In some cases\npatients with corneal ulcers require admission to the ward for intensive hourly\nantibiotic drops. <\/span><\/p>\n\n\n\n<p>JC &amp; BC 28\/1\/26<\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-\u2013-Lothian-GP-and-Optometry-Ophthalmology-Referral-Pathway.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Ophthalmology-\u2013-Lothian-GP-and-Optometry-Ophthalmology-Referral-Pathway.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Please see Lothian GP and optometry ophthalmology referral pathway<\/a>.<\/p>\n\n\n\n<p><a href=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urgency-of-the-condition.pdf\" data-type=\"link\" data-id=\"https:\/\/apps.nhslothian.scot\/files\/sites\/2\/Urgency-of-the-condition.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Urgency of the condition<\/a>&nbsp;for details on how soon patients should receive an appointment.<\/p>\n\n\n\n<p>Patients who present with a problem with their only seeing eye should be advised to see an optician\/ophthalmologist for review.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p><strong>We require a referral letter for EVERY patient<\/strong>.<\/p>\n\n\n\n<p>The preferred referral process is via SCI Gateway. If sending\/forwarding a referral via SCI gateway please include past medical history, allergies and medications<\/p>\n\n\n\n<p>If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.<\/p>\n\n\n\n<p>Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.<\/p>\n\n\n\n<p>If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8203;Patients with suspected ulcers or contact lens keratitis should be referred to ophthalmology for further management and investigations Always have a high level of suspicion in patients who wear contact lenses if they present with a painful red eye. Consider keratitis even if they have had an injury suggesting abrasion\/foreign body. They require examination under<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4282,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[494],"class_list":["post-3823","page","type-page","status-publish","hentry","category-cornealulcercontactlenskeratitis"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/ophthalmology\/painfulredeye\/cornealulcercontactlenskeratitis\/\" rel=\"tag\">Corneal Ulcer - Contact Lens Keratitis<\/a>","rttpg_excerpt":"&#8203;Patients with suspected ulcers or contact lens keratitis should be referred to ophthalmology for further management and investigations Always have a high level of suspicion in patients who wear contact lenses if they present with a painful red eye. Consider keratitis even if they have had an injury suggesting abrasion\/foreign body. They require examination under","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3823","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3823"}],"version-history":[{"count":9,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3823\/revisions"}],"predecessor-version":[{"id":26423,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3823\/revisions\/26423"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4282"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3823"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3823"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}