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Consultant Ophthalmologist, Cataract & Refractive Surgeon
BMedSci BM BS MRCS MRCSEd MRCOpth FRCOphth MMedLaw PgD Cataract & Refractive Surgery

Your patient has a corneal opacity/scar

Patients are often diagnosed as having a corneal opacity, and the optometrist may be concerned that the patient has a corneal ulcer. If the eye is red and painful, the patient should be referred urgently to the hospital eye service. Try to avoid giving antibiotic drops unless ophthalmology review will be delayed. Topical antibiotics may affect the pick-up rate of the hospital's corneal microbiology scrapes.

If the eye is white and the patient asymptomatic, there is unlikely to be any infection.

Ask the patient if they have had a previous eye injury that would explain the scar.

If the patient is asymptomatic and the eye is not red, then you have the option of simply observing the patient. If they develop symptoms such as blurring of vision, it is worth referring them routinely. If the eye subsequently becomes red, treat it as a corneal ulcer until proven otherwise.