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Expression of conjunctival follicles (eg, for trachoma)

CPT4 code

Expression of Conjunctival Follicles (eg, for Trachoma)

Name of the Procedure:
  • Common Name: Expression of Conjunctival Follicles
  • Technical Term: Conjunctival Follicle Expression
  • Specific Example: Used in Treatment of Trachoma
Summary

Expression of conjunctival follicles is a medical procedure where the doctor carefully expresses (squeezes out) the small, raised bumps on the inside of the eyelids, known as follicles. This is often done to treat or manage trachoma, an infectious eye disease.

Purpose
  • Medical Condition: Trachoma, a bacterial infection that can cause blindness.
  • Goals: To remove the infected follicles, reduce inflammation, and prevent the progression of the disease, thereby protecting eyesight.
Indications
  • Presence of chronic eye redness, irritation, and discharge.
  • Diagnosed with trachoma or similar conditions causing conjunctival follicles.
  • Patients experiencing persistent follicles that do not respond to antibiotic treatment alone.
Preparation
  • Pre-Procedure Instructions: Patients may be advised to stop using certain eye medications prior to the procedure.
  • Assessments: A thorough eye examination and history of symptoms. In some cases, laboratory tests to confirm trachoma may be necessary.
Procedure Description
  1. Anesthesia: Local anesthesia (eyedrops) is applied to numb the eye and reduce discomfort.
  2. Cleaning: The eye area is cleaned to prevent infection.
  3. Expression: Using a small, sterilized tool called an expression spatula or a similar instrument, the doctor gently presses on the conjunctiva to express the follicles. This may be repeated across the affected areas.
  4. Post-Procedure Care: The eye may be rinsed with a sterile saline solution and antibiotic eye drops may be applied.
Duration
  • The procedure typically takes 15 to 30 minutes.
Setting
  • Usually performed in an outpatient clinic or eye specialist's office.
Personnel
  • Ophthalmologist or an eye specialist.
  • Assisting nurse or medical technician.
Risks and Complications
  • Common: Mild discomfort and temporary redness.
  • Rare: Infection, excessive bleeding, and potential for scar tissue formation if not done correctly.
  • Management: Use of antibiotics and anti-inflammatory medications post-procedure to minimize risks.
Benefits
  • Immediate: Relief from symptoms such as pain and irritation.
  • Long-term: Reduced risk of blindness and decreased recurrence of follicles with appropriate follow-up care.
Recovery
  • Post-Procedure Care: Use prescribed eye drops and avoid rubbing the eyes.
  • Recovery Time: Typically, a few days to a week.
  • Follow-up: Regular check-ups to monitor healing and ensure no new follicles have formed.
Alternatives
  • Medical Treatment: Long-term antibiotic therapy.
  • Pros and Cons: Antibiotics can be effective but may take longer to show results and may not always fully resolve follicles.
Patient Experience
  • During: Slight pressure and discomfort due to the expression process, mitigated by anesthesia.
  • After: Mild soreness and redness which usually subsides within a few days. Pain can be managed with over-the-counter pain relief if necessary.

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