Any Drs/pharmacists or HCPs around? Eye problem

[TheoriginalLEM]

My DP went to the Drs this morning with a swollen eyelid. Its red and sore. Dr prescribed chloramphenical. It seems to be getting worse since he has applied the cream. Should he stop and go back to dr? it looks really angry and swollen now - he says the eye hurts now rather being sore if that makes sense.

I'm no health professional but I'd suggest he stopped using the cream and go back to the GP. In the meantime try salt water, being careful not to get it in the eye.

If his eye hurts when he's moving it he'll need to be seen again tonight. Especially if the eye area is starting to look puffy.

That, and pain rather than irritation, is a sign of more significant infection than a simple conjunctivitis and he may need oral antibiotics at a minimum.

Straight to OOH. I had exactly this and it was peri-orbital cellulitis. Twice. Potentially serious if not treated properly. Had 2 different types of antibiotics.

That's exactly what I'd be worried about Bonzo. You poor thing having it twice!

Hmmm, more chance of getting him to jump off a cliff that getting him to OOH tbh. He is going to go to the Drs in the morning again. He has washed off the cream and says it feels a bit better. The worrying thing is having googled (I KNOW) it looks more like peri-orbital cellulitis than a stye or conjunctivitis.

Well in that case I'd take a photo of it now, and again in an hour or two. If it doesn't look marginally better and especially if it looks worse, push him to go to OOH.

Is it the eye ball that's painful? If so, off to the eye hospital straight away. Don't leave it.

Just to add, I'm a GP. I wouldn't consider this time wasting at all if I was on call.

Gahhhh!!! he wont call OOH - no surprises there - bloody men. Stubborn. He did say its not the eyeball that hurts which is something I will kick him out the door first thing in the morning and make sure he sees our doctor.

I made him take an antihistamine to see if that reduces the swelling which it will i guess if its an allergy (he is allergic to cats)

I had similar last october, there was nothing stopping it and I ended up in hospital on IV antibiotics for 4 days.

The first thing they did in hosp was outline the red area with marker, they could then see v quickly if it was responding to treatment or not. Would he let you do this so you could keep an eye on it?

Personally I would go to OOH or Eye A&E of nearest hosp if you have one.

Peri/Orbital cellulitis can progress pretty quickly. PS my eyeball didn't hurt either.

It wasn't sore at all for me. Irritated definitely. The first time I treated it with eye ointment at first as I thought it was conjunctivitis. Once I got to ooh they said if it didn't improve within 12 hours I needed to go to Moorfields for IV antibiotics. Second time I caught it much earlier and it was far less dramatic. Ironically I found out I was pregnant shortly after the first episode (meant I'd conceived with it, nice). Luckily the abs given are considered fine in pregnancy!

It looked alot worse this morning Although it looked odematous rather than swollen if that makes sense. I have packed him off the the Dr this morning. Hoping it doesn't result in a hospital visit as i know he will not want to go.

It is peri-orbital cellulitis. He has been sent home with oral anti-biotics. Hopefully they will do the trick.

Keep a close eye. If it's not changed or has got worse in 24 hours he needs to go back. Inadequately treated it can spread backwards towards the brain.

Agree with Bonzo. Have a low threshold to get him seen again if no improvement.