Dry Eye Disease

Question 1

3-4 conjunctivitis red flags?

Answer 1

Contact lens wearer
Chronic bacterial conjunctivitis (sx lasting longer than 4 wks)
Loss of visual acuity (blurred vision, halos)
Severe photophobia
Moderate- Severe pain
Ocular trauma (fingernail, mascara wand, branch)
Unable to confirm diagnosis or self care not appropriate.

Question 2

what are the 2 primary signs/sx of conjunctiviits?
- what are other sx that MAY be incldued?

Answer 2

REDNESS
SOME type of discharge

MAY include: foreign body sensation, scratching or burning, a feeling of fullness around the eyes, itching, mild photophobia, +/- morning crusting.

Question 3

what are 3-4 non pharm tips?

Answer 3

Proper handwashing and avoid rubbing eyes.
Avoid sharing personal items (towels, pillow cases, eye makeup)
D/c contacts
Warm compresses to soften crusts
Cold compresses to relieve irritation and redness
Allergen avoidance (wear big sunglasses)

Question 4

What are the OTC options for ALL type of conjunctiviits?

Answer 4

lubricant drops or ointments

Question 5

What is an OTC recomemndation for acute BACTERIAL conjunctivitis?

Answer 5

Polymixin B-gramcidin ophthalmic drops.
Directions: Instil 1 to 2 drops FOUR times per day for 5 to 7 days.

If no improvement within 2 days, discontinue and follow up with primary care provider or optometrist

Question 6

What is an OTC recomemndation for acute allergic conjunctivitis? (3)

Answer 6

Antihistamine/decongestant ophthalmic drops:
Appr. for short term use (<10-14 days) or episodic use
Contain a decongestant (e.g. naphazoline, oxymetazoline, phenylephrine, tetrahydrozoline) and antihistamine (i.e. pheniramine).

Mast cell stabilizer ophthalmic drops (i.e. sodium cromoglycate):
NOT FOR SHORT TERM/ PRN USE (takes up to 14 days to effect). For regular use prior to allergen exposure.

Systemic antihistamines
Maye help for itching, but eye drops more effective.

Question 7

What are TWO firstline PRESCRIPTION OPTIONS FOR BACTERIAL CONJUNCTIVITIS?

Answer 7

Firstline:
Erythromycin 0.5% eye ointment
Directions: Apply one-half inch (1.25 cm) FOUR times per day for 5 to 7 days
Dose may be reduced to 2 times per day after a couple of days if symptoms are improving.

Fusidic acid 1% eye drops (>2 yrs)
Directions: Instil 1 drop TWO times daily for 7 days.

Trimethoprim-polymixin B 0.1%-10,000 units/ml eye drops (>2 months)
Directions: Instil 1 to 2 drops every THREE hours (4 to 6 times per day [max]) for 5 to 7 days

Tobramycin 0.3% ophthalmic drops or ointment (Age ≥ 1 year)
Directions for drops: Instil 1 to 2 drops every FOUR hours for 5 to 7 days
Directions for ointment: Apply one-half inch (1.25 cm) TWO to THREE times daily for 5 to 7 days

Question 8

What IS THE ONE FIRSTLINE PRESCRIPTION OPTION FOR allergic conjunctivits?

• what is second line?

Answer 8

First line: Dual action antihistamine/mast cell stabilizer eye drops.
Fast onset of action; good for immediate sx relief.
May take up to 2 weeks for max effect.

Olopatadine 0.1%, 0.2%, 0.7% ophthalmic drops.
Directions for 0.1%: Instil 1 to 2 drops TWO times daily, allowing SIX to EIGHT hours between doses (Patient ≥ 3 years old)

Ketotifen 0.025% ophthalmic drops (Patient ≥ 3 years old)
Directions: Instil 1 drop every EIGHT to TWELVE hours

second line:
Mast cell stabilizer eye drops -> Lodoxamide 0.1% ophthalmic drops (Patient ≥ 4 years old)

Question 9

biggest a/e for all abx eyedrops?

Answer 9

stinging