GP CCE Cases · eye-presentations
Contact-lens wearer with red painful eye — CCE clinical encounter
CCE-style clinical encounter: a 24-year-old contact-lens wearer with a red, painful right eye, photophobia and reduced vision. The candidate must recognise Pseudomonas keratitis risk, remove the lens, refer urgently without patching, and address lens hygiene education.
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Target exams
RACGP CCEFRACGP oralsCFPC SOOs
Prompt
A 24-year-old barista attends urgently: her right eye has been red and painful since waking this morning. She wears monthly disposable contact lenses and admits to sleeping in them 'most nights'. Vision in the affected eye is reduced. She has photophobia. Fluorescein staining reveals a white corneal infiltrate with surrounding uptake at the paracentral cornea.
Objectives
- Recognise contact-lens keratitis as Pseudomonas until proven otherwise. [3]
- Perform systematic assessment including fluorescein staining. [3]
- Remove the contact lens and arrange urgent same-day ophthalmology referral. [3]
- Explain why patching is contraindicated. [3]
- Deliver lens hygiene education for future prevention.
References1ShowHide
- [3]Sheikh A, Hurwitz B, van Schayck CP, McLean S, Nurmatov U Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev, 2012.PMID 22972049