Eye Flashcards
Eye drop counselling
Squeeze one drop into pocket formed by pulling eyelid down
Don’t touch eye, keep dropper clean
Keep eye closed a minute after putting drop inside eye
If using more than 2 different drops at the same time wait 5 minutes
Don’t drive until vision is clear
Ointment used after drops
Contact lenses and eye drops
Hard lenses - still use drops whilst wearing
Soft lenses - remove lense first, use PF as drugs expires can accumulate on the lens
Never wear any when using ointment
Rifampicin and Sulfasalazine can stain the lenses
Eye drop expiry
Use home for 28 days (unless stated)
Hospital use for 1 week
Op/surgery/ minims = single use only
Eye drop preperarations
Eye drops sterile
Make sure to avoid contamination during use
Max use for 4 weeks unless stated e.g hylo forte 6 months
Single dose drops discard after use - minims
Preservatives
Benzalkonium chloride can cause stinging and irritation
Pred forte
Is a suspension
Shake before use
Allergic conjunctivitis
Bilateral eyes affected
Watery discharge
Redness and itchy eyes
Topical eye drops; sodium cromoglicate (2+ years P or 6 yrs GLS)
Oral; cetirizine 10 mg tablets (6+), cetirizine solution (2+), loratadine (2+), chlorphenamine tablets (6+), chlorphenamine solution (1+), promethazine tablets (5+) solution (2+)
Bacterial conjunctivitis
Initially unilateral (but can be bilateral)
Purulent discharge, redness may have respiratory tract infection symptoms
Self care; hygiene measures
Chloramphenicol eye drops or ointment max 5 days not in pregnancy
Chloramphenicol eye drops
Drops and ointments
Under 2 need a prescription but can supple 2+ by pharmacy
Broad spectrum antibiotics
Not for pregnancy
Harder to use ointment in children as its thicker
Blepharitis
Edges of eyelids become red and swollen
Sore eyelids, itchy eyes and gritty feeling
Treat by cleaning eyes every day - if not working may need abx
Stye
Small lump on the eyelid caused by an infection
Putting on warm flannel on the affected eye or use of painkillers
Keratitis
Corneal ulcer
Inflammation of the cornea
Possible blindness
Intensive antibiotic course with ciprofloxacin
Can be caused by bacteria, viruses, fungi and parasites, wearing contact lenses for long time or whilst swimming
Trachoma
Disease of the eye
Infection with bacterium chlamydia trachomatis
Lead to blindness and visual impairment
Mild itching and irritation, eyelid swelling, can turn eyelashes inwards in severe cases
Antibiotic; azithromycin, doxycycline or tetracycline taken by mouth
Cytomegalovirus retinitis
Viral infection of the retina of the eye
Inflammation
Herpes simplex type virus
Blind spots, blurred vision and other Vision problem and floaters
Eye infections bacterial
Chloramphenicol - superficial eye infections
Aminoglycosides - p. Aeruginosa
Ciprofloxacin - corneal ulcers
Azithromycin - c.trachomatis
Fusidic and staph infections - blepharitis
Viral fungal eye infections
Herpes simplex infections
Aciclovir, ganciclovir ; 5 times a day until 3 days after healing
Fungal eye infections
Rare
Test in labs
Treatment not generally available
Specialist centres
Red eye flags
Pain in the eye
Unequal or misshapen pupils
Neonatal sticky eye
Ciliary injection
Trauma to the eye
Unable to see (visual problems)
Miserable towards light (photophobia)
Glaucoma
Loss of visual field due to increased IOP
Can lead to optic nerve damage and vision loss
2 types; chronic open angle and acute closed angle
Chronic open angle glaucoma
Asymptomatic
Irreversible sight loss
Most common
Ocular hypertension >21 mmHg
Acute angle closure glaucoma
Less common
More serious
Sight threatening
Medical emergency
S/E; nausea and vomiting, cloudy eye, intense eye, brain, sight loss etc
Glaucoma treatment for eye drops
1st line BB
2nd line; sympathomimetic, carbonic anhydrase inhibitors
Glaucoma eye drops type
Prostaglandin analogue - latanoprost, bimatoprost, travaprost (s/e; change in iris, eye lash hair, redness, stinging)
Carbonic anhydrase inhibitor - dorzolamide, brinzolamide (s/e eye discomfort), acetozolamide orally
Beta blocker - timolol (s/e; stinging, burning, itchiness eye)
Sympathomimetics - brimonidine (s/e; eye discomfort, itchiness, redness)
If side effects occur change to preservative free
Ocular hypertension
Treat; control IOP, prevent development of glaucoma
Prostaglandin 1st line for IOP >24 mmHg
A topical prostaglandin analogue if not then BB if not then CA inhibitor (alone or in combination)
