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2021 Pre-registration > Chapter 11: Eye > Flashcards

Chapter 11: Eye Flashcards

1
Q

Counsel a patient on administering eye drops.

A

Form a pocket by pulling down your lower eyelid, instil the eyedrop, keep eye closed for 5-10secs or long as possible to allow absorption.

wash hands before and after

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2
Q

Counsel a patient on administering eye ointment

A

Pull down your lower eyelid, line against your lashline and blink to help spread the ointment

wash hand before and after

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3
Q

A patient has newly been prescribed eye ointment and eye drops they ask you which to use first. What do you say?

A

Drops first, then ointment

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4
Q

If two eye drops are co-prescribed how long should a patient wait between using them and why?

A

5mins due to dilution and overflow

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5
Q

Which eye formulation can cause transient blurred vision?

A

Ointments (thicker and greasier so 10-15m) especially at night so caution with driving

Drops - few minutes

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6
Q

Eye medication that have phosphate as an ingredient demonstrate a risk of ___________

A

Corneal damage (v. rare)

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7
Q

Expiry dates for eye drops.

A

At home: discard after 4 weeks or 28 days
Hospital: do not use after 7 or 14 days dep on trust
Outpatient or surgical: single application

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8
Q

Using contact lenses for prolonged periods of time increases the risk of _________

A

infectious and non-infectious keratitis/ conjunctivitis

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9
Q

Why do people prefer preservative free eye drops?

A

Preservative e.g. benzalkonium can cause stinging and irritation

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10
Q

If someone wears contact lenses which formulations will be more suitable?

A

Hard lenses: Eye drops oK

Soft lenses e.g. silicone: Remove lenses prior to using eye drops (even if using PF eye drops the preservatives can accumulate)

Ointments/oily eye drops: never wear lenses during use

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11
Q

Give examples of some drugs that can stain contact lenses and what colour?

A

Rifampicin - red bodily secretions and lenses

Sulfasalazine - Orange stain

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12
Q

Give examples of drugs that reduce blink rate?

A

Anxiolytics
Hypnotics
Anti histamines
Muscle relaxants e.g. baclofen, quinine

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13
Q

Give examples of drugs that reduce lacrimation?

A 
Antihistamines
Antimuscuranics
Phenothiazines
B-blockers
Diuretics
TCS: amitryp, nortrip
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14
Q

A drug used for severe acne can cause corneal inflammation due to its drying SE. What drug is this?

A

isotretinoin

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15
Q

Which drug can cause lens irritation due to its absorption via lens?

A

Aspirin (salicylic acid in it)

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16
Q

Risks associated with prolonged topical corticosteroid use in eyes?

A

1) steroid cataracts
2) red eye = corneal ulceration and potential damage to the eye
3) steroid glaucoma

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17
Q

What is the intravitreal implant oxurdex licensed for?

A

High cost drug - needs funding

Macular oedema

18
Q

What is allergic conjunctivitis

A

Result of allergens e.g. hayfever/pollen

19
Q

What OTC products can be used for allergic conjunctitivitis?

A

sodium cromglicate - mast cell stabiliser
Available OTC - 10ml, apply QDS
SE: stinging

Anti histamine eye drops: antazoline
Vasoconstricors: reduce redness e.g. xylometazoline

20
Q

Signs of allergic conjunctivitis?

A

Both eyes, clear watery eyes, redness, itchy

21
Q

Dry eyes options?

A

Hypromellose hourly PRN

Carmellose QDS - thicker and more moisturising so longer relief

22
Q

3 types of eye infections?

A

Conjunctivitis - bacterial (treat with chloramphenicol 5x a day for 5days every 2hrs first 2 days then every 4 hrs next three days - 2yrs+ - FRIDGE) or viral (self limiting but if associated with herpes then use aciclovir 5x a day and 3 days after healing)

Blepharitis - eye lid infection (use fuscidic acid if pus-y and staphylococci infection) + daily hygiene eg eye lid wipes and cleansers)

23
Q

Indications for topical corticosteroids?

A

Steroid glaucoma and cataracts

24
Q

If corticosteroids are used in infections e.g. HSV what is the risk?

A

Aggravates infection and leads to corneal ulcers that can cause blindness (if occurs use ciproflox eye drops every 15 mins for 1st 6hrs)

25
Q

When eye examinations occur, your pupils are dilated via drugs. Give examples of the drugs used.

A

Phenylephrine and atropine

26
Q

Phenylephrine must not be used with _____ due to the risk of

A

MAOIs due to the risk of hypertensive crisis

27
Q

What is glaucoma? Can you think of a systemic medication that causes glaucoma as a SE?

A

Raised intraocular pressure

Prednisolone / steroids

28
Q

1st line for glaucoma? What is the contra-indication?

A

B-blockers e.g. Timolol, betaxolol
Contra indicated in asthma - bronchospasm even though they are eye drops

OR

Prostaglandins generic as more cost effective (brands are 3rd line option) e.g. bimatoprost, latanoprost (report eye irritation within a week)

29
Q

Side-effects of prostaglandins e.e.g bimatoprost?

A

Darker iris colour - brown
longer eye lashes

Avoid repeated contact with solution

30
Q

2nd line for glaucoma?

A

Sympathomimetics e.g. brimonidine

Carbonic anhydrase inhibitors e.g. brinzolamide (acetazolamide is taken orally)

31
Q

Which eye condition is a medical emergency?

A

Closed angle glaucoma - RISK OF BLINDNESS

Cloudy eyes
N/V
Headache 
Intense eye pain
blurred hazy vision
sight loss
Rainbow rings around lights
32
Q

Licensed age for steroid e.g. dexamethasone eye drops (maxidex)?

A

2yrs +

33
Q

Symptoms of dry eye?

A

Soreness and inflammation at the ocular surface - use tear replacement therapy

34
Q

Medication used to treat dry eye?

A

hypromellose

carbomer - less frequent application

35
Q

An eye infection with pseudomonas can be treated with?

A

Gentamicin
Quinolones (except moxifloxacin)
Tobramycin

36
Q

Chloramphenicol licensing OTC?

A

2yrs+ and max 5 days use (4g pack size)

37
Q

Side-effects of chloramphenicol?

A 
Angio-oedema
Bone marrow disorders 
Stinging 
Fever
Skin rx
38
Q

Which eye drops used in herpetic keratitis requires contraception for both men and women for atleast 90 days of treatment?

A

Ganciclovir

39
Q

Risk factors for glaucoma (inc intraocular pressure)?

A 
T2DM
Corticosteroid use 
Age
Family hx 
Ethnicity
CVS disease
Hypertension
40
Q

which medication for glaucoma can be given orally?

A

Acetazolamide

41
Q

Common SE of acetazolamide?

A

haemorrhage so ask patients to report rashes due to blood disorders

42
Q

Which eye drop has an MHRA warning to report eye irritaion within a week?

A

Latanoprost

2021 Pre-registration (15 decks)

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