Correspondence (letter to the editor): Useful Pointers

The authors rightly wrote that the cornea should be inspected closely (1). Epithelial defects of the cornea are, however, usually masked by lachrymal fluid, especially in epiphora, with the result that someone without much practice and without a slit lamp will easily miss them.

Using the vital color dye fluorescein can be extremely useful in this setting. Applying the dye shows with great clarity erosions, scratches caused by subtarsal foreign bodies, or the typical dendritic shape in recurrent Herpes simplex infection. In epithelial defects, steroid eyedrops are usually contraindicated.

It is also recommended to have local anesthetic eyedrops to hand during the consultation. Especially in patients who are not able to cooperate or persons with severe eye pain—as in blepharospasm—examination is otherwise almost impossible. The drops are also helpful when removing surface foreign bodies.

The primary care physician may even be able to prevent blindness, as in case of chemical burns, blepharospasm makes careful rinsing of the eye without local anesthesia pretty much impossible, and in this scenario, the time lag before the patient presents to an ophthalmologist can be crucial. For GPs, it is recommended that they keep a store of the required eyedrops as single-dose ophthioles.