Monitoring

Post-operative management is directed at preventing infection, suppressing inflammation, and controlling intra-ocular pressure. Frequent follow-up is necessary, paying attention for early signs of endophthalmitis, suture exposure, and retinal damage.

Chemical burns

  • Daily follow-up required until stable.

Corneal epithelial defects

  • Every few days until healed.

Hyphaema

  • Daily follow-up for the first 5 days, when the risk of re-bleeding is highest.

  • Monitor patients for complications (e.g., glaucoma, cataracts, retinal tears, or retinal detachment) after 1 week, and then every 2 weeks thereafter.

Eyelid lacerations

  • Follow-up depends on the nature and extent of the injury. In wounds thought to be at high risk for infection, a wound check may be done 24-48 hours after the injury.

  • Skin suture removal is often performed 5-7 days after a lid laceration. However, if the eyelid margin has been repaired, those sutures may be left in longer (10-14 days).

  • Eyeball lacerations involving the margin or tear duct system should be managed by an experienced ophthalmologist.

Foreign bodies

  • Corneal foreign bodies that were not embedded or cleanly removed by an ophthalmologist should have follow-up in 24-48 hours.

  • If a corneal rust ring is present, follow-up with an ophthalmologist in 1-2 days is needed for removal.

  • Intra-ocular foreign bodies require close follow-up by a specialist.

Open globe injuries

  • Ensure close follow-up after the initial repair to monitor for the development of post-traumatic endophthalmitis or retinal detachment. These are sight-threatening emergencies that require prompt diagnosis and treatment.

  • Perform vitrectomy early in cases of vitreous involvement to prevent or repair retinal detachment.

  • Complete vitrectomy within the 7-14 day period after the primary repair to reduce the risk of proliferative vitreo-retinopathy.[102][103]

  • Monitor patients for complications (e.g., glaucoma, cataracts, retinal tears, or retinal detachment) after 1 week and then every 2 weeks thereafter.

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