Table 16.
A Suggested Practice Protocol for Managing Ophthalmic Incidents in the Aesthetic Practice
| Retinal ER | Contact person | Document time ……….. |
| Mobile number | …………………….. | |
| Address | …………………….. | |
| Practice | Reporting staff member | …………………….. |
| Injecting physician | …………………….. | |
| Stop injecting! | Staff: Call Retinal ER | Document time ……….. |
| Product | What injected | …………………….. |
| Where (area) | …………………….. | |
| How much | …………………….. | |
| When | Time of injection……………. | |
| Time of cessation……………. | ||
| Patient complaint | Vision reduced | R/L……………. |
| Symptom | Pain/Diplopia/Skin | R/L……………. |
| Other symptoms | …………………….. | |
| Test eyes separately | (Occlude opposite eye) | |
| Test vision + Document | ||
| Light perception | Y/N | |
| Hand movement | Y/N | |
| Finger count | Y/N | |
| Snellen chart (app) | …………………….. | |
| Available reading material | …………………….. | |
| Pupillary reflex | R eye: Y/N | L eye: Y/N |
| Medical RX decompress | Aproclonidine drops Timolol 0.5% drops *Bimatoprost drops |
Every 15 minutes |
| Acetazolamide 500mg | Oral | |
| Acetylsalicylic acid *Nitroglycerin 0,6mg |
Sublingual | |
| Ocular massage | Supine, eyes closed | Firm pressure 5–15 sec, release Repeat cycle 5x |
| Rebreathing (vasodilatory) | Brown paper bag | 10 minutes per 30 minute cycles |
| Hyaluronidase (dissolve) | >1000–1500 IU |
|
| Emergency transfer |
|
|
Note: *Conflicting evidence.
Abbreviations: RB, retrobulbar; PG, peribulbar; ST, supratrochlear artery; SO, supraorbital artery.