MS-3601

You are working on a medical ward and you are asked to review a patient for painful red eyes. He is a 55-year-old man who is a current inpatient being investigated for unstable angina. His eyes have been intermittently gritty and painful for several months. He denies itch, decreased vision or recent coryzal symptoms. On examination, you find bilaterally injected conjunctivae, low tear film volume and diffuse corneal staining with fluorescein dye. His lid margin appears crusted with misdirected eyelashes.

What is the most appropriate first-line treatment?