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fornix reconstruction, optical penetrating keratoplasty and  keratoprosthesis
                            surgeries.

                   STANDARD OPERATING PROCEDURE


                        a. In Patient :
                         Infants diagnosed to have ophthalmia neonatorum due to gonococci chlamydia
                          and HSV are admitted as they need systemic evaluation and appropriate systemic
                          treatment.
                          Prolonged  persistent  conjunctivitis  with  development  of  complication  like
                          cicatrization, lid abnormalities, dry eye, symblepharon and punctal anomalies.
                          Severe chemical conjunctivitis with limbal ischaemia and suspected intra ocular
                          penetration of toxic substances.

                       b. Out  Patient:  If  the  patient  requires  only  modification  of  the  topical  anti-
                          infectives, then he/she can be treated as an outpatient.
                        c. Day Care: not applicable.

                   d)     Referral criteria: not applicable.


               V.      WHO DOES WHAT? AND TIMELINES


                           a. Doctor :

                         Patient history is taken and a clinical examination performed
                         Conjunctival  infective material is obtained by scrapping and smear are prepared
                          and also materials are  inoculated  directly onto culture media

                         Documenting the medical record
                         Plan  treatment  guidelines  and  perform  surgery  if  necessary.  Monitoring,
                          publication  and  reporting  to  department  of  health  if  there  is  an  epidemic
                          conjunctivitis and if there is an emergence of drug resistance pathogen.
                         He/she  plays  a  critical  role  in  breaking  the  chain  of  transmission  of  epidemic
                          adenoviral  conjunctivitis,  primarily  by  educating  the  patient  and  family  about

                          proper hygiene.
                         He/she should also ensure that needy patients receive necessary care directly or
                          through referral to appropriate persons and facilities that will provide such care,
                          and he or she supports activities that promote health and prevent disease.
                          b.   Nurse/Technician:

                         Prepare Slide, Media for smear and culture.

                         To monitor the patients who are admitted.
                         To maintain separate inpatient and outpatient record.
                         To maintain lab reports.


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