Questions

A 68-year-old female presents to the Emergency Department with a 6-hour history of severe right eye pain, headache, nausea, and blurred vision. She describes the eye pain as a constant ache with associated redness. Her past medical history includes hypertension, type 2 diabetes, and depression. Current medications include Amlodipine 5mg OD, Metformin 1g BD, and Sertraline 50mg OD.

On examination: Temperature 37.2°C, HR 92/min, BP 158/94, RR 18/min, SpO2 98% on air. The right eye shows conjunctival injection, a mid-dilated unreactive pupil, and a hazy cornea. The eye is tender to touch with reduced visual acuity (6/60). Left eye examination is normal. Visual acuity 6/6.

Which of the following is the most appropriate immediate management?