II. Preparations: Medications

  1. Topical Eye Anesthetic
    1. Tetracaine 0.5%
      1. Onset in 1 minute and lasts for 30 minutes
    2. Proparacaine 0.5%
      1. Onset in 20 seconds and lasts for 15 minutes
  2. Topical Eye Antibiotic
    1. See ophthlamic antibiotic
    2. Bacitracin ophthalmic ointment
    3. Erythromycin 0.5% ophthalmic ointment
    4. Gentamicin 0.3% ophthalmic ointment
  3. Topical Mydriatics and Cycloplegics
    1. See Mydriatic
    2. Precautions
      1. Exercise caution with Mydriatics in Glaucoma, and avoid in acute angle closure Glaucoma
    3. Mydriatic only
      1. Phenylephrine ophthalmic 2.5%
        1. Onset in 20-30 minutes and lasts for hours
        2. Risk of Chemical Eye Injury
    4. Mydriatic and Cycloplegic (Anticholinergics)
      1. Tropicamide (Mydriacyl) 0.5 to 1%
        1. Onset in 20 minutes and lasts for 6 hours
      2. Cyclopentolate (Cyclogyl) 1% (0.5% in children)
        1. Onset in 30 minutes and lasts for up to 24 hours
      3. Homatropine 2% solution
        1. Onset in 30 minutes and lasts for 2-4 days
        2. Avoid in children

III. Preparations: Instruments

  1. General exam instruments
    1. Visual Acuity Chart (e.g. Snellen Chart, Handheld Rosenbaum Chart)
    2. Flashlight or penlight
    3. Ophthalmoscope
    4. Slit Lamp
    5. Handheld Tonometer with disposable covers (e.g. Tonopen)
    6. See Eye Ultrasound
  2. Eye Foreign Body exam
    1. Medical Magnifying Glasses (e.g. Optivisor headband magnifier)
    2. Fluorescein dye strips and wood's lamp (for Corneal exam)
    3. Sterile cotton swab (moistened with Topical Eye Anesthetic)
    4. 18 gauge needle (eye Foreign Body Removal with needle tip)
    5. Corneal Burr with sterilized tip (rust Ring Removal)
    6. Eye Shield and tape or eye patch
  3. Eye Irrigation
    1. pH Paper
    2. NS 1 liter bag, IV tubing and morgan lens or eye wash station
    3. Plastic basin

IV. References

  1. Sales, Patel and Patel (2019) Crit Dec Emerg Med 33(12): 3-13

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