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Triage and time-critical risks
Vision-threatening priorities
Rapid ophthalmology involvement for suspected infectious keratitis
If central ulcer
If large infiltrate
If hypopyon
If marked vision reduction
Immediate escalation for perforation risk
If Seidel positive
If stromal melt
Immediate safety checks
Contact lens removal
Lens saved in sterile container for possible culture
Topical anesthetic limited to exam only
No outpatient topical anesthetic due to corneal toxicity risk
Hemodynamic and systemic instability screen
Sepsis concern
If fever
If immunocompromised with systemic symptoms
Key Concepts
Core framing
Corneal ulcer as stromal infiltrate with epithelial defect
High risk of rapid scarring in visual axis
Risk of corneal thinning and perforation
Microbial keratitis as ophthalmic emergency
Time-to-therapy linked to visual outcomes
Working diagnosis labels for coding
ICD-10 corneal ulcer
H16.0
H16.00
SNOMED CT concepts
Corneal ulcer
Infectious keratitis
Immediate decision points
Endophthalmitis concern
Severe pain out of proportion
Vitritis concern
Marked vision loss
Recent intraocular surgery or injection
Emergent ophthalmology
Orbital cellulitis concern
Pain with eye movements
Proptosis
Restricted extraocular movements
Open globe concern
Penetrating trauma history
Misshapen pupil
Shallow anterior chamber
Seidel positive
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