You are in ambulatory care and a client reports redness of the sclera, itching, and tearing for several hours. What should you direct the caller to do first?

• A. Please call your physician
• B. Apply a cool compress to your eyes.
• C. If you are wearing contact lenses, remove them
• D. Take an over-the-counter antihistamine

Answer: (C)

The key action is to remove the contact lenses first. When eye redness, itching, and tearing occur, especially in someone who wears lenses, the lenses can trap irritants, bacteria, or moisture behind the cornea and continue to irritate or even contribute to infection or corneal injury. Taking the lenses out immediately stops that ongoing pressure and irritation, reduces the risk of further damage, and allows the eye to be assessed and treated more safely. After removing the lenses, avoid reinserting them and seek professional evaluation promptly, particularly if symptoms persist, worsen, or are accompanied by pain, decreased vision, or discharge. A cool compress may provide comfort, but it doesn’t address the potential lens-related issue as effectively as removing the lenses. Calling a physician or taking an antihistamine can be considered after the lens removal, depending on symptoms and clinical judgment.