C09999785 / invoice 10000

Reason: FB In Eye?Consultation time: 7.30pm  History:Presenting problem:Acute onset wound OS noticed this afternoon. Eliza (vet nurse) suspects ocular FB based on appearance. Tried flushing with water. Given gabapentin 200mg and meloxicam dose at home.   Previous medical history/medications:Previous ocular FB in 2022  Examine:  Sedate, MM pink/moist, CRT <2BCS 4/9, MCS 4/4Temperament: Spicy little lady!Eyes: OS corneal opacity with discharge and blepharospasm, OS NSFENT: NSFRemainder externall normal on distance exam Problem list:2 x corneal lesions, suspect one with corneal perforationAssessment:Given no evidence of aqueous leak, deep FB, or iris/lenticular involvement, OK to trial analgesia and fluoroquinolone eye drop  Client communication:Discussed findings and case with Eliza throughout visit, who did a great job of holding Joey safely and comfortably. Discussed risks with corneal perforation, but that I am hopeful this will be OK given it appears as superficial as possible. Discussed that ophtho would be ideal but difficulty given Friday night; if eye appears worse at any time, recommend ophtho on call. Treatment: Alcaine 0.5% 1 drop OSFlushed cornea with sterile saline and gently probed with q-tip to ensure no FB, aqueous leak, nor true prolapse.Fluorescein stain OS 2 x uptake centrally (1) ~1mm vertical with perforated corneal epithelium (2) pinpoint without obvious corneal perforation. No visible or palpable FB, aqueous does not appear to be leaking. Anterios chamber appears unremarkable and lens, iris do not appear involved. IOP OS 20-24, OD 15-17Atropine 1% 1 drop OS Photo taken and emailed to clinic emailPlan:Treatment plan - Ofloxacin OS q2 x 2 days then q4 until recheck - owner is vet nurse so will monitor closely and FU at work or with ophthalmologist Continue gabapentin (Rx 100mg caps) and meloxicam at homeAttempted blood collection for autologous serum but unable to collect blood - can consider when Eliza returns to work    Vital Signs    Weight: 2.95;       

    Vital Signs    

Reason:  sore left eye for 2 days.Owner has given an oral dose of meloxicam yesterday and today.Not had eye problems before.Today the left eye looks slightly blue.Examine: Left eye keratitis1mm central cornal spot which has a 0.5mm black superficial foreign body in the centre. Suspect this is a seed-cap.Treatment: Apply alcaine.Easily blasted off the foreign body with a jet of saline.Flouroscein--->+ve 1mm ulcer.Tricin TID.Could give one more dose of meloxicam tomorrow.Eliza is a vet nurse so can re-strain the ulcer tomorrow.    Vital Signs    Weight: 2.9;