C09976405 / invoice 10000

Appointment Reason: Check Eyes, Appointment Notes: see ARH reportunable to put cream in eyesaware $103 plus tests/medsdiscussed if needing nurse to administer meds, tomorrow, etc, there will be a fee.  JHWith tamiHistory:Seen at ARH last week Had bilateral large corneal ulcers Was groomed on the day, so suspect she had either hair or shampoo in her eyes causing irritation, then scratched them Struggling with the chloramphenicol to get the ointment in - aiming for TID but finding sometimes they are just getting it on the eyelids not in the eyeYesterday morning her eyes were quite gunky and eyelids stuck shut - cleaned her eyes and today they have been clearObjective:BARVery wriggly for exam Eyelids very oily from the ointment No perilimbal hyperaemia Mild central corneal oedema Fluorescein stain - small 1mm pinpoint ulcer on each cornea centrally Assessment:Bilateral corneal ulcers - improving Plan:RV thursday for repeat fluorescein staining Continue meloxicam and keep buster collar on Can try chlorsig drops from pharmacy rather than the ointment as may be easier to apply     Vital Signs    Weight: 8.3;