Case Study Of The Emergency Eye Clinic At East Surrey Hospital

– A 50-year-old male was referred to the emergency eye clinic at East Surrey Hospital in Canada Avenue for a history of three-day deteriorating bilateral eye pain, redness and quick reduction of visual acuity in the past 24 hours. The patient had no past medical or ocular history. The patient visual acuities (VA) were a light perception (LP) in the right eye (RE) and a hand movement (HM) in the left eye (LE).
– The patient was a contact lens wearer and got the daily disposable soft (silicone hydrogel) lenses from the Internet without optometrist review. The patient reported having left the contact lenses (CL) intact for more than three weeks, having worn CL for two weeks with “no problem” before and desire to extend the wearing time even more to save money. ………..
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There was a 5 mm hypopyon in the right eye, and no view of the posterior segment in both eyes. The CL were not intact during the examination.
– Corneal scrub and cultures revealed bilateral bacterial growth of Pseudomonas aeruginosa. The patient was managed with hourly ciprofloxacin drops combined with oral levofloxacin, and topical dexamethasone 0.1% drops which resulted in healing of the epithelial defect.
– By day seven after the treatment, the RE showed a reduction of corneal stromal infiltrate and resolution of hypopyon, and the LE showed clearing of the cornea at the periphery and reduction of stromal infiltrate. The vision in the RE at day 28 following the treatment had improved to HM only as a result of severe right corneal stromal scarring. On the other hand, the VA had improved to 6/12 in the LE with further reduction in the stromal