Prior to referral, commence first aid treatment with a drop of pilocarpine 2% eye drops in blue eyes
(for brown eyes use a drop of pilocarpine 4% eye drops)
PoM Give a single dose of 500 mg oral acetazolamide (Diamox)
Use plain preparation of Diamox (avoid slow release formulation)
Do not give if patient vomiting
Do not give if systemic contraindication
Advice
Emergency referral to ophthalmology required
Management Category
Emergency referral to ophthalmology
Possible management by Ophthalmologist
Intensive topical ocular hypotensive therapy
Systemic ocular hypotensive therapy
Peripheral iridotomy
Lens extraction
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Introduction and disclaimer
The Eyecare Guidelines area of the eyes.nhs.scot website (“Website”) is intended as a reference source for education and clinical decision support and is intended for use by ophthalmic healthcare professionals.
As such, the Eyecare Guidelines are not intended for use by the general public and does not replace the advice of a healthcare professional. Members of the public should seek advice directly from their optometrist.
The Eyecare Guidelines were originally adapted from the College of Optometrists’ Clinical Management Guidelines (CMGs), to incorporate pragmatic experience gained from NHS Grampian’s Eye Health Network.
However, this content is currently under review. The most up-to-date versions of the College of Optometrists’ CMGs can be accessed
at https://www.college-optometrists.org/clinical-guidance/clinical-management-guidelines.
The information on the Eyecare Guidelines area of the Website provides guidance and related information for the differential diagnosis, possible management by optometrists (treatment and advice),
management category and possible management by ophthalmologists. Users should note that that the Eyecare Guidelines will not be suitable for every situation and is not intended to be a substitute for specialist expertise and clinical judgement.
Users should also note that the Eyecare Guidelines should not be adhered to in isolation and should be considered in conjunction with other national and locally available guidance/pathways..
Unless indicated otherwise on a specific guideline webpage, users should note that the Eyecare Guidelines have not been updated for several years and thus should be considered with caution.
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these links are provided for information only. To the maximum extent permitted by law, the Eyecare Guidelines is made available on the basis of excluding all representations, warranties, conditions and other terms
(including, without limitation, the conditions implied by law of satisfactory quality, fitness for purpose and the use of reasonable care and skill) which, but for this disclaimer, might have effect in relation to the Eyecare Guidelines.
Users assume all responsibility for using the information on the Eyecare Guidelines area of the Website.
