Which client is most in need of immediate examination by an ophthalmologist?
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With the patient in the supine position, irrigate the eye copiously with ophthalmic irrigant, with the patient’s head turned laterally toward the affected side. Show
Instill one to two additional drops of local anesthetic. 3.Apply an antibiotic ointment or drops. For patients who wear contact lenses, keratitis should be ruled out and antipseudomonal antibiotic drops should be chosen (see above for details). Even under the best of conditions, infection is a possibility because of the avascular nature of the cornea. Prophylaxis with antibiotic ointment or drops is important. Note: In the past, eye patching was thought to decrease pain from a corneal abrasion by decreasing blinking and reducing eyelid-induced trauma. By being a physical barrier, it was also thought to reduce the risk of infection and prevented the patient rubbing their eye when asleep. However, at least one meta-analysis and several subsequent randomized clinical trials have found no benefit to patching regarding either pain or healing. In fact, eye patching was the source of pain in 48% of patients in one study! Furthermore, eye patching decreases oxygen delivery,increases heat and moisture, and may increase the risk of infection. In various trials, ophthalmic topical NSAIDs provided pain relief that was superior to patching. As a result of this evidence, many clinicians no longer use eye patching. However, the technique for patching remains in this chapter as an option. The evidence is somewhat lacking for lesions greater than 10 mm in diameter. Another option that is being used, but needs more study in the hands of primary care clinicians, is a soft contact “bandage” lens as a protective barrier. This is an excellent option for the busy patient who must have continuous use of both eyes. As long as the cause of the abrasion was not a contact lens, the use of a soft contact lens usually provides comfort and protection and should not impair healing. However, if a soft contact lens is used, the patient should be followed closely and warned about signs of infection. 4.Pain medication should be prescribed in an amount appropriate to the symptoms. However, additional local anesthetic should not be prescribed because it may retard corneal healing and cause corneal scarring. Topical ophthalmic NSAIDs such as ketorolac (Acular) or diclofenac (Voltaren) have been found to reduce pain by about 14% compared with placebo. A systematic review of the literature found that patients using ophthalmic NSAIDs may take fewer oral analgesics, return to work earlier, and take fewer narcotics. 5.In the past, mydriatics were thought to relieve the pain related to ciliary muscle spasm associated with any corneal abrasion. Although there is minimal evidence supporting this practice, it may be reasonable to use a mydriatic when there is obvious spasm, iritis, or irregularity of the pupil (these patients should also be referred to an ophthalmologist). It may also be reasonable to use a mydriatic when the patient presents with photophobia or significant eye discomfort. 6.Re-examine the eye in 24 hours using fluorescein and magnification. If the abrasion has healed, antibiotic ointment or drops should be used for an additional 3 days. If the defect is smaller, instill antibiotic ointment and examine again in 24 hours. If at any time during the follow-up corneal cloudiness or suppuration is seen, refer the patient to an ophthalmologist. 7.The visual acuity test should be repeated and documented just before the patient is discharged from care. 8.Tetanus prophylaxis should be verified or provided. Note: Abrasions resulting from fingernails or plant matter are notoriously slow to heal. Their progress should be followed patiently, just like any other abrasion, while observing for any signs of early infection. 9.(Optional) A double patch (pressure patch) can be used. Before patching, an ophthalmic ointment (as opposed to solution) should be applied. The first patch is then folded and the fold placed immediately under the upper brow (this adds padding and prevents opening of the eye). This patch is covered with the second patch. With three to five strips of paper tape, secure the patches by taping from the middle of the forehead, across the eye, and toward the ear (Fig. 200.5) Note: If infection is suspected, an eyepatch is contraindicated. Also, abrasions from organic material have fungal potential, so they should not be patched. Abrasions due to contact lenses increase the risk of infection withPseudomonas so they should not be patched. Do not use eyepatches on young children. There is the theoretical risk of permanently affecting the use of one eye or of making amblyopia worse. Very young children typically remove a patch anyway. View chapter on ClinicalKey Corneal AbrasionSherleen Chen MD, FACS, in Decision Making in Medicine (Third Edition), 2010 Corneal abrasions typically heal rapidly (within 1–2 days) depending on the extent of injury and the patient's age and health. The most important management issues are to exclude more severe injury and to allow healing without infection. Topical anesthetics should never be prescribed for pain control because chronic use is toxic to the corneal epithelium. A.If the abrasion is associated with a significant mechanism of injury (e.g., high-velocity foreign body), contact with vegetable matter such as a bush or tree, or associated contact lens wear, the patient should be referred to an ophthalmologist for examination because these situations have potential for more serious injury or more virulent or atypical pathogens. B.On penlight examination, a corneal abrasion may show a normal corneal light reflection or an isolated irregular corneal light reflection in the area of the abrasion. Fluorescein staining and examination under cobalt blue light will outline the area of denuded epithelium as a yellowish-green stain. C.Patients with recurrent erosion syndrome report a history of recurrent episodes of awakening with symptoms of a corneal abrasion. The examination is often normal because the abrasion has often healed by the time the patient is seen. Patients should use aggressive lubrication with artificial tears QID and erythromycin or another bland ointment QHS for 1 month. An ophthalmology referral should be pursued if the patient is still symptomatic. D.Multiple linear streaks of fluorescein staining indicate a foreign body embedded in the upper lid until proved otherwise. After everting the upper lid to remove the foreign body, the abrasion is treated as indicated for small abrasions (see section E). The upper lid also should be everted if the patient reports a history of a foreign body in the eye. E.Small abrasions are treated with ophthalmic ointment tid–qid, such as erythromycin, polymyxin/bacitracin, or bacitracin ointment. Antibiotic ointments with steroids are contraindicated. Patients are seen within 1–2 days to ensure complete resolution of the abrasion without complication. F.Large abrasions are treated with antibiotic ointments as noted in section E. In addition, pressure patching for 24 hours may decrease pain and aid in healing. A folded eye pad is placed over the closed lid and covered with a second eye pad. Tape is applied diagonally across the forehead to the patient's cheekbone to tightly secure the pad and prevent blinking. An eye patch should never be applied if there is recent history of contact lens wear, potential vegetable matter, or a potential infection. Oral analgesics can be prescribed as needed for 1 day. Topical anesthetics should never be prescribed. Patients should be seen within 24 hours to ensure healing is progressing without infection, or they should be referred to an ophthalmologist. The branching pattern of a corneal dendrite indicates herpetic eye disease. The patient should be referred to an ophthalmologist for further evaluation and management. H.Immediate ophthalmology referral should be sought for concerning findings such as a corneal opacity, embedded foreign body, a shallow anterior chamber, or an irregular pupil. These signs indicate significant injury or potential infection. View chapterPurchase book Read full chapter URL: https://www.sciencedirect.com/science/article/pii/B9780323041072501654 Red EyeRick D. Kellerman MD, in Conn's Current Therapy 2021, 2021 Corneal AbrasionCorneal abrasions typically result from scratching of the corneal epithelium due to trauma, but they can also occur from extended-wear contact lenses. Patients with corneal abrasions present with pain, excessive tearing from the involved eye, photophobia, a foreign-body sensation (like having sand in the eye), and blurry vision. Corneal abrasions are identified by staining the cornea with fluorescein and examining under cobalt blue light (Figure 3). The eye should also be examined carefully to check for foreign bodies. Topical anesthetic is administered to make the patient comfortable during the examination, but continued use can cause corneal damage. Management of corneal abrasions consists of pain relief and prevention of infection. Pain can be relieved with topical NSAIDs such as ketorolac (Acular)1 and Diclofenac (Voltaren),1 oral over-the-counter analgesics, and occasionally oral narcotics. Topical antibiotics are usually prescribed to prevent infection. Antibiotic ointments are lubricating and soothing to the eye, making them a good option for traumatic corneal abrasions. Topical ophthalmic antibiotic ointments commonly used are bacitracin (Bacticin), erythromycin (Ilotycin), and gentamicin (Gentak). In patients who have corneal abrasions from contact lens overwear, eyes are commonly colonized withPseudomonas aeruginosa. These patients should be treated with topical antibiotics such as ciprofloxacin (Ciloxan) or ofloxacin (Ocuflux) solutions. Patching of the eye, though a common practice of the past, has not shown evidence of benefit in recent studies. It was found that eye patching can actually cause harm, so this practice is no longer recommended. Infrequently, patients have traumatic uveitis accompanying corneal abrasion. Traumatic uveitis usually causes significantly more pain than a corneal abrasion, and, if uveitis is suspected, the patient should be evaluated by an ophthalmologist. Patients with corneal abrasions should be reexamined in 24 hours. Corneal abrasions typically should be healed or greatly improved in 24 hours. If the abrasion is not completely healed after 24 hours, the patient should be examined again in 2 or 3 days. Referral should be considered if any worsening occurs or if the abrasion does not heal within 5 days. Corneal abrasions can be prevented by using protective eyewear. View chapter on ClinicalKey Corneal AbrasionPhilip Buttaravoli MD, FACEP, in Minor Emergencies (Second Edition), 2007 What To Do:Instill topical anesthetic drops to permit examination (e.g., proparacaine [Ophthetic], tetracaine [Pontocaine])Perform a complete eye examination (including assessment of best-corrected visual acuity, funduscopy, anterior chamber bright-light examination, and inspection of conjunctival sacs for a foreign body).Perform the fluorescein examination by wetting a paper strip impregnated with dry, orange fluorescein dye and touching this strip into the tear pool inside the lower conjunctival sac. After the patient blinks, darken the room and examine her eye under cobalt-blue filtered or ultraviolet light. (The red-free light on the ophthalmoscope does not work.) Areas of denuded or dead corneal epithelium will fluoresce green and confirm the diagnosis.If a foreign body is present, remove it and irrigate the eye.When a corneal abrasion is present, treat the patient with antibiotic drops such as trimethoprim plus polymyxin B (Polytrim), 10 mL, 1 drop q2-6h while awake. Some physicians prefer ophthalmic ointment preparations, which may last longer but tend to be messy. If ointment is preferred, erythromycin 0.5%, 3.5 g, or polymyxin B/bacitracin, 3.5 g, applied inside the lower lid (1-2 cm ribbon) qid is effective and least expensive. In patients who wear contact lenses or who were injured by organic material (such as a tree branch), an antipseudomonal antibiotic (e.g., ciprofloxacin [Ciloxan] 0.3%, 1-2 drops q1-6h, or ofloxacin [Ocuflox] 0.3%, 1-2 drops q1-6h, should be used. Contact lens wearing should be discontinued until the abrasion is healed.Analgesic nonsteroidal anti-inflammatory eye drops of diclofenac (Voltaren), 0.1%, 5 mL, or ketorolac (Acular), 0.5%, 5 mL, 1 drop instilled qid, provide pain relief and do not inhibit healing.If iritis is present (as evidenced by consensual photophobia or, in severe cases, an irregular pupil or miosis and a limbic flush in addition to conjunctival injection), consult the ophthalmologic follow-up physician about starting treatment with topical mydriatics and steroids (see Chapter 20).Even when there are no signs of iritis, one instillation of a short-acting cycloplegic, such as cyclopentolate 1% (Cyclogyl), will relieve any pain resulting from ciliary spasm.Although not likely to be available to the non–contact lens user, a soft, disposable contact lens (e.g., NewVue, Acuvue) in combination with antibiotic and nonsteroidal anti-inflammatory drops can provide further comfort as well as the ability to see out of the affected eye. As with any contact lens worn overnight, there is probably an increased risk for infectious keratitis, so this should be provided in concert with an ophthalmologist.Prescribe analgesics (e.g., oxycodone, ibuprofen, naproxen) as needed, and administer the first dose when appropriate. Most abrasions heal without significant long-term complications; therefore, pain relief should be our primary concern with uncomplicated abrasions. This treatment of pain should be guided by an individual patient's age, concomitant illness, drug allergy, ability to tolerate NSAIDs, potential for opioid abuse, and employment conditions, such as driving and machine operation.Warn the patient that some of the pain will return when the local anesthetic wears off.Make an appointment for ophthalmologic or primary care follow-up to reevaluate the abrasion the next day. If the abrasion has not fully healed, the patient should be evaluated again 3 to 4 days later, even if he feels well.Instruct patients about the importance of wearing eye protection. This is particularly needed for persons in high-risk occupations (e.g., miners, woodworkers, metal workers, landscapers) and those who participate in certain sports (e.g., hockey, lacrosse, racquetball). Other preventive measures include keeping the fingernails of infants and children clipped short and removing objects such as low-hanging tree branches from the home environment.View chapterPurchase book Read full chapter URL: https://www.sciencedirect.com/science/article/pii/B978032308346150022X OphthalmologyRon M. Walls MD, in Rosen's Emergency Medicine: Concepts and Clinical Practice, 2018 Corneal AbrasionsThere is no evidence that treatment of corneal abrasions with topical antibiotics, as often recommended, has any beneficial effect. Furthermore, the infection rate of untreated corneal abrasions is low—at 0.7%—and prophylactic antibiotic use is not warranted. We recommend that antibiotics not be used for uncomplicated corneal abrasions (that are not deep, not imparted by a heavily contaminated object, and not in high-risk patients), especially because the indiscriminate prescribing of these agents introduces the risk of toxic and allergic medication reactions in the eye. It is reasonable, however, to empirically treat a corneal abrasion in a contact lens wearer or immunocompromised patient with an anti-pseudomonal agent such as tobramycin, ciprofloxacin, or ofloxacin, as outlined inTable 61.1 (although for a shorter course than would be prescribed for an already established infection; ie, 3 to 5 days).2 A major goal in the treatment of a corneal abrasion is managing the pain. Topical nonsteroidal antiinflammatory drugs (NSAIDs), such as ketorolac or diclofenac (seeTable 61.1) are options.3 Prospective trials have revealed that topical anesthetics self-administered as needed for a short duration of time by ED patients for corneal abrasion pain results in significant pain relief without complications.4,5 Meta-analyses incorporating these trials as well as postoperative ophthalmology literature support this finding.6,7 A patient with a corneal abrasion can therefore be provided a limited 24- to 48-hour course of a topical anesthetic (seeTable 61.1), because the most intense pain occurs in the first 24 hours. This being said, uninformed patients using over-the-counter topical anesthetics for otherwise simple corneal injuries can develop an erosive keratopathy.8 Regardless of whether this association is due to masking the pain of an emerging infection or due to a direct toxic effect from a misused anesthetic, it is important to counsel patients on the correct and limited use of these agents. Eye patches are not recommended, because they can mask a worsening infection. Urgent ophthalmologic consultation is warranted with signs of active infection, such as a corneal infiltrate (whitening of the cornea) or ulceration (seeCorneal Ulcers and Infiltrates later); otherwise, the patient can follow up with an ophthalmologist in 24 to 48 hours. View chapter on ClinicalKey Ophthalmic Problems and ComplicationsScott D. Cook-Sather, in Complications in Anesthesia (Second Edition), 2007 PROBLEM ANALYSISDefinitionCorneal abrasion is the most common perioperative ophthalmic complication, with an incidence of 0.1% to 44%. A higher incidence was reported in the 1970s for anesthetized patients without eye protection or lubrication. Most corneal abrasions result from corneal drying associated with lagophthalmos during general anesthesia. RecognitionSymptoms of corneal abrasion include photophobia, pain, and foreign body sensation. Excessive tearing and miosis are characteristic physical findings. Staining with fluorescein reveals the abraded zone in green under a cobalt blue light (Fig. 173-1). Risk AssessmentAlthough the inciting event for corneal abrasion is not always clear, factors such as prone or lateral positioning and exophthalmos place patients at higher risk. General anesthesia increases the risk, in part owing to lost protective corneal reflexes, abolished Bell's phenomenon (in which the globe turns upward during sleep), and diminished tear production and stability. ImplicationsThe majority of children sustaining intraoperative corneal abrasion have a full recovery within 24 hours with appropriate treatment. Extensive injury or delayed treatment results in a 16% incidence of permanent injury. Permanent scarring is usually related to secondary corneal infection or abrasions that are chronic. View chapterPurchase book Read full chapter URL: https://www.sciencedirect.com/science/article/pii/B9781416022152501782 Oral, Ocular, and Maxillofacial TraumaRan D. Goldman MD, Steven G. Rothrock MD, in Pediatric Emergency Medicine, 2008 Corneal AbrasionCorneal abrasions are the most common eye injury in all ages and are especially common among older children who wear contact lenses. Although found in about 10% of visits with a chief complaint related to eye problem in EDs, the actual estimated incidence of corneal abrasions in children is not known. Current management of corneal abrasion in children is based on treatment established in adults. Recommended therapy consists of eye patching, cycloplegic drops, and antibiotics. Cycloplegic drops prevent discomfort from ciliary spasm, and antibiotics are administered to prevent infection.42 In the past, patching was thought to facilitate healing and to relieve pain due to decreased shearing forces over the defect.43 However, routine use of a patch has been questioned because it impairs binocular vision; obscures half of the visual field; may carry a risk for anaerobic infections, particularly in children using contact lenses; and does not improve the rate of healing.44,45 Although no clear evidence exists, many ophthalmologists prescribe a topical antibiotic (e.g., fluroquinolone) for infection prophylaxis after corneal abrasion in children. All children except those with a very mild corneal abrasion should have a slit-lamp examination. In all significant corneal injuries, examination by an ophthalmologist is desirable for management and further follow-up after discharge from the ED. Close follow-up care of children with corneal abrasions is necessary because of a possible progression of the abrasion to an ulcer. View chapterPurchase book Read full chapter URL: https://www.sciencedirect.com/science/article/pii/B9781416000877500192 Ocular injuriesIn The Ophthalmic Assistant (Ninth Edition), 2013 Corneal abrasionsCorneal abrasions are superficial scratches and erosions of the cornea (Figs 19-6 and 19-7). They are found after corneal foreign bodies have been removed, either spontaneously or with treatment. They are most commonly found after injuries caused by paper, fingernails, wires, and so forth. A corneal abrasion, unless it is large, cannot be seen with the naked eye. Patients with a corneal abrasion complain of a foreign body sensation of the eye. Often these patients are seen by a nurse or a friend and told that there is nothing in their eye and as a result they suffer until they are finally seen by the ophthalmologist. Any patient who complains of a foreign body sensation of the eye should be seen. Fluorescein strips should be placed in the eye (Figs 19-8 and 19-9) to stain the area of the corneal defect and the eye should be examined with magnifying glasses. Corneal abrasions are treated by firm patching for 24 hours. The larger the abrasion, the more time it takes to heal. A bandage contact lens may minimize pain. This is the case after laser PRK. View chapterPurchase book Read full chapter URL: https://www.sciencedirect.com/science/article/pii/B9781455710690000190 Craniomaxillofacial InjuriesAllyson S Howe MD, in The Sports Medicine Resource Manual, 2008 Corneal abrasionDefinitionCorneal abrasion involves superficial injury to the cornea (the transparent layer of tissue that covers the iris). Corneal abrasions account for up to 10% of new patients visits in eye emergency units of the United Kingdom. In primary care offices where eye complaints account for 2% of patient visits, 8% of eye patients are diagnosed with abrasions.7 Mechanism of injuryA scratch or superficial contact with an object that drags across the eye causes this type of injury. In sports, this is commonly the finger of an opposing player that pokes into the unprotected eye. Risk factorsPlaying sports in which no protective eye gear is worn may put an athlete at increased risk of corneal abrasion. Contact lens wearers are at higher risk of corneal abrasions due to improperly fitted or cleaned lenses. Clinical featuresThe nerves of the cornea come from the trigeminal nerve, and they are among the most sensitive in the body. An athlete with a corneal abrasion will complain mostly of pain in the eye. He or she may note blurry vision and the feeling that a foreign object is in the eye, and he or she may recall trauma to the eye. On examination, there may be copious tearing, pain with opening the eye fully, or photophobia. The eye may be red or have an injected sclera (a prominence of superficial blood vessels seen through the sclera). DiagnosisDefinitive diagnosis is paramount to a good outcome. The use of a topical anesthetic in the eye (e.g., tetracaine eye drops) may be necessary for the patient to tolerate examination. Fluorescein dye should be used to stain the corneal epithelium. Use of a Wood lamp or a cobalt blue filter during a slit-lamp examination can highlight corneal damage because the accumulation of fluorescein at the site of injury will be visible under this special lighting. TreatmentSimple corneal abrasions should heal in 2 to 3 days, with no long-term complications.8 Topical antibiotic coverage is indicated for most patients with a corneal abrasion to prevent secondary bacterial infection. This treatment has not been well studied, but it is commonly used to help prevent tragic complications. Antibiotic choices are listed in Box 22.1. The decision for tetanus toxoid administration is controversial. Superficial or uncomplicated corneal abrasions do not require a booster, but tetanus toxoid may be protective in the case of penetrating eye trauma.9 Patching the eye has not been shown to decrease pain or shorten healing times (LOE: B).8 Treatment with nonpatched eyes improves compliance with medications and treatment (LOE: B).8 Contact lens wearers should be told to avoid use of their contact lenses during treatment and healing. At the time of initial diagnosis, the lesion size should be measured. Close follow-up examination within 24 hours to assess for healing is important, and subsequent daily examinations are necessary until resolution. Any corneal abrasion that does not demonstrate a daily decrease in size or that has not healed after 3 days should be referred to an ophthalmologist. A corneal abrasion can progress to a corneal ulceration, which is a devastating injury that requires urgent specialty consultation with an ophthalmologist if it is suspected. A patient should never be sent home with a topical anesthetic because these medicines may inhibit wound healing or lead to further corneal injury in the patient who has an occult foreign body (see Box 22.1). Return to playAn athlete may return to play after the abrasion has fully healed and visual acuity has returned to normal. ControversiesTetanus toxoid has not been shown to be necessary, but it is often given in cases of corneal abrasion. An animal study demonstrated a greater need for tetanus toxoid if penetrating eye injury has occurred but no need for tetanus in the case of superficial, uncomplicated injury.9 Eye patches are not recommended for the treatment of corneal abrasions that are not infected and that are not related to contact lens trauma because their use may retard healing and negatively affect compliance with therapy (LOE: B).8 View chapterPurchase book Read full chapter URL: https://www.sciencedirect.com/science/article/pii/B9781416031970100229 Ocular PainSteven D. Waldman MD, JD, in Pain Review, 2009 CORNEAL ABRASIONSCorneal abrasions are another frequent cause of eye pain that prompts patients to seek urgent medical attention. The unique nature of the sensory innervation of the corneal results in the patient's perception of foreign body in the eye anytime the superficial corneal stroma is injured and the C-type polymodal nociceptors that richly innervate the cornea are stimulated. The foreign body sensation is usually felt by the patient as being located under the upper eyelid even when there is no foreign body present and damage is limited to the corneal stroma. The continued firing of the polymodal receptors and recruitment of the corneal mechanoreceptors are probably responsible for this foreign body sensation associated with corneal abrasion that occurs in almost all patients with corneal abrasion even in the absence of foreign body. Patients presenting with corneal abrasion will usually relate a history of grit or a foreign body being blowing into the eye or a history of minor mechanical trauma to the cornea during the insertion of contact lens or while playing sports. Fluorescein staining will usually reveal the damage to the corneal stroma, and rarely will a foreign body will be seen. The patient will bitterly complain of severe pain that is out of proportion to the apparent injury and will insist that there is something trapped under the upper eyelid even after repeated attempts to convince the patient to the contrary. Photophobia and excessive lacrimation and scleral and conjunctival injection are often present, as is a significant substrate of anxiety. In the presence of corneal abrasion, the clinician should evert the upper eyelid and rinse the eye with copious amounts of sterile saline solution to remove any residual foreign body that may not be readily apparent on initial investigation. If the corneal abrasion is the result of an accident that occurred during hammering or the use of power tools, a careful search for a metallic foreign body should be undertaken and a plain radiograph or computed tomographic scan of the orbit and orbital contents should be obtained to rule out occult intraocular metallic foreign body, which can present a significant risk to vision if undetected. Treatment with non–neomycin-containing antibiotic ointment such as gentamicin or polymyxin B and bacitracin ophthalmic ointment combined with patching of the eye and a large dose of reassurance will usually resolve the problem. What is the action of miotics in the client with glaucoma?Miotics are eye drops that cause the pupil to constrict, allowing the blocked drainage angle to open. They may be used two, three, or four times daily. These medications are now reserved for use in people whose glaucoma does not improve with other medications.
What type of eye drops would be ordered for the patient who is being prepared for cataract surgery?Before Surgery
2 days before your surgery, begin using Vigamox and Prolensa eye drops, which will be prescribed by your physician. This is an antibiotic eye drop. This medication has a tan top. Take 1 drop of Vigamox or generic 4 times a day.
What activities will the nurse tell the client to avoid after cataract surgery?They include:. Don't do any strenuous activities for a few weeks. Avoid rigorous exercise and heavy lifting.. Don't drive. ... . Follow your doctor's orders regarding any antibiotic and anti-inflammatory eye drops. ... . Stay away from dusty areas. ... . Don't rub your eye. ... . Don't swim. ... . Don't wear make-up.. Which of the following symptoms would occur in a client with a detached retina?Symptoms include flashes of light, floaters or seeing a shadow in your vision. Floaters are dark spots and squiggles in your vision. You may experience warning signs like these before the retina detaches, as in the case of retinal tears. Retinal detachment often happens spontaneously, or suddenly.
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