Conjunctivitis Flashcards
Introduction
- *W**ash hands
- *I**ntroduce yourself
- *P**atient’s consent
- *E**xplain procedure/purpose for Hx
PC
“What brought you in today?”
HPC
Explores patient’s history:
“Is it both eyes that are affected?”
Pain/”grittiness” - “did you get any pain in your eyes?”, “do you have a gritty feeling in your eyes?”
Asks about foreign body - “Did any material get into your eye like a chipped piece of wood?”
Visual acuity - “Have you had any changes in your vision?”, “are you still able to see things in the same way before your symptoms started?”
Contact lenses - “do you use contact lenses?”
Discharge - “have you had any discharge from your eye?”, “what colour was the discharge?”
Photophobia - “do you get very sensitive to light?”
Associated symptoms
Runny nose/ sore throat, contacts with similar symptoms, fever (G for all, A for 2) - “have you had a runny nose or sore throat?”, “have you been in contact with anyone that also had similar symptoms?”
Symptoms of hayfever e.g. itchy eyes/ throat - “have you got hayfever? Do you have itchy eyes and a itchy throat?”
ICE
Ideas - “what do you think could have caused your symptoms?”
Concern - “is there anything that your worried about regarding your symptoms?”
Expectation - “what were you hoping we would do for you today?”
PMH
“Do you have any medical conditions like dry eyes or any eye conditions?”, “Have you ever had symptoms like this before in the past?”
DH
- “Are you on any medications that have been prescribed by your doctor?”, “do you take any over the counter medications?”*
- “Do you have any allergies to any medications? What happens when you take the medication?”*
SH
Alcohol, smoking, recreational drugs (including IVDU) - “do you smoke?”, “how much do you smoke each day?”, “how long have you smoked for?”, “have you ever smoked? How much did you smoke and for how long?”(if the patient said they don’t smoke),”do you drink?”, “how much/what do you drink each day?”, “do you use recreational drugs?”, “have you ever injected drugs or shared needles with other people?”
Occupation - “do you work?”, “what do you do for work?”
Home situation - “what’s your home situation like?”, “do you need help with things like cooking, washing/cleaning yourself?”
FH
“Does anyone in your family have any eye problems?”
DDx
Explains most likely conjunctivitis but considers corneal ulcer
“Given the information you’ve given me, it’s likely that you have conjunctivitis, which is when one of the layers that in your eyes get inflamed. It could also be a corneal ulcer, due to the fact that you use contact lenses”
Examination
Offers to examine patient (G if specifically mentions visual acuity/Snellen chart)
Suggests inspection to exclude foreign body (G if considers use of fluorescein and blue light)
Counselling
Explains self-resolving nature of conjunctivitis - “Conjunctivitis is usually self-resolving”
Provides advice on self-care: cotton wool and clean water, hand hygiene/ avoid sharing towels (G for both) - “practical things you can do is making sure that you’re washing your hands reguarly, using cotton-wool and clean water to clean your eyes. Also it’s important that you don’t share towels with anyone else to prevent it from being passed on”
Avoid using contact lenses; use glasses instead - “Also, for now avoid using your contact lenses and wear glasses instead”
Advises 1. antibiotic drops not indicated but 2. can consider chloramphenicol drops if bacterial cause suspected (G if both) - “for treatment, because the symptoms you’re getting is unlikely to be caused by a bacteria, you don’t need antibiotic drops, however if there is any suspicion of a bacterial cause, you can use chloramphenicol drops”
Safety-netting
“Return immediately or go to eye casualty if there is a sudden visual loss. Also, return in 5-7 days, if your symptoms aren’t getting better or sooner if pain gets worse” (3 for G)
Close consultation
“Thank you so much for speaking with me today. Before you go I’d like to give you a patient information leaflet. A great website to go to is NHS choices, which I’ll write on a piece of paper for you to take home with you.”
