Eye And Ear Flashcards
allergic conjunctivitis symptoms
Usually bilateral (effects both eyes)
irritation
discomfort
water discharge
Infective conjunctivitis can be …… or …….
Bacterial
Viral
Bacterial conjunctivitis vs viral conjunctivitis
Bacterial has a sticky purulent discgarge whereas viral conjunctivitis is more watery discharge
Allergic vs infective conjunctivitis
Allergic conjunctivitis usually bilateral
Infective can be unilateral or bilateral
When do you rule our presence of a foreign body in eye conjunctivitis
If one eye is affected
When to refer in conjunctivitis
Painful red eye
Redness extending to the iris
Photophobia
Vision affected (loss/blurred vision)
Pt using other eye drops/ointments
Suspected foreign body in yeye
Irregular pupil
Eye/head injury
Eye looks cloudy
Symptoms last longer than 2 weeks
Pregnant /breastfeeding
Can chloramphenicol eye drops be used in pregnancy?
Orally?
Avoid unless essential—no information on topical use but risk of ‘neonatal grey-baby syndrome’ with oral use in third trimester.
Can chloramphenicol be used when breastfeeding
Avoid; may cause bone-marrow toxicity in infant;
concentration in milk usually insufficient to cause ‘grey syndrome
Treatment options for bacterial conjunctivitis
Chloramphenicol
Propamidine isetionate
Whats the first line treatment for bacterial conjunctivitis
Whats it’s brand name
Chloramphenicol
Optrex infected eye drops
Whats the chloramphenicol course duration for conjunctivitis
5 day course
Whats the chloramphenicol % for eye drops and ointment
0.5% eye drops
1% ointment
Whats the chloramphenicol eye drops dose for bacterial conjunctivitis
One drop into affected eye/s every 2 hours for the first 48hrs then one drop every 4 hours for remaining 3 days
Wheres chloramphenicol eye drops stored
In the fridge (2-8 degrees)
Whats the OTC age for chloramphenicol eye drops
Aged 2 and over
Whats the storage for chloramphenicol eye ointment storage
Store at room temperature
Chloramphenicol eye ointment dose
Apply 3-4 daily
Why cant you give chloramphenicol to new born infants
Risk of grey baby syndrome (aplastic anaemia) in new born infants
Brolene and golden eye drops active ingredient and indication
Propamidine isetionate
Bacterial conjunctivitis and blepharitis
Propamidine isetionate dose for bacterial conjunctivitis
QDS
Storage of Propamidine isetionate/ brolene, golden eye drops
Room temperature
Age restrictions of brolene and golden eye drops
No age restrictions
Allergic conjunctivitis treatment
Brand?
Sodium cromoglycate 2% eye drops
Optrex allergy
Sodium cromoglycate 2% MOA
How do you use it
Mast cell stabiliser
Requires regular use
Can sodium cromoglycate 2% be used alongside oral antihistamine treatment
Yes it is safe to do so
Sodium cromoglycate 2% age restrictions
Licensed for 6 years and above
Allergic conjunctivitis treatment
Sodium cromoglycate 2%
Contact lenses advice in Conjunctivitis
They shouldn’t be worn until 24hrs after the infection has cleared
Eye drop preparations expire …. Days after opening
28 days
Dry eye syndrome symptoms
Itchy, Tired, Burning sensation
Sensitive to light/ eye redness
String like mucus in eye
Night time driving difficulty
Difficulty wearing lenses
Feeling like somethings in the eye
Is dry eye syndrome bilateral or unilateral
Usually bilateral
Dry eye syndrome treatment
Artificial tears- hypromellose, carmellose, polyvinyl alcohol, carbomer gel
Carbomer gel indication
Dry eye syndrome
Polyvinyl alcohol indication
Dry eye syndrome
Dry eye syndrome counselling on preservatives
Benzalkonium chloride is a preservative present in eye drops, if it causes eye irritation you can get preservative free preparations.
Blepharitis symptoms
Itchy, sore, red eye life
Eyelids stick together when wake up
Eyelashes crusty/greasy
Edges of eyelids become swollen
Uncomfortable to wear lenses
Is blepharitis bilateral or unilateral
Usually bilateral
Blepharitis tends to be worse at what time of day?
Morning
Blepharitis red flags
Unresponsive to treatment
Constant dry eyes
Concurrent conjunctivitis
Swelling on inside of eye lid
Stye
Photophobia, eye pain, worsening vision
Blepharitis management
Self care
Propamidine isetionate- brolene and golden eye drops
Propamidine isetionate dose for blepharitis
QDS
Can blepharitis be cured
No, but symptoms can be managed
Counselling patients on blepharitis
Avoid eye makeup unless easily washable
Can have preservative free preparations if irritation occurs with benzalkonium chloride
Explain Blepharitis self care management
Warm compress in closed eyelid for 5-10 minutes (helps melt oils in glands behind eyelids)
Gently rub the eyelids vertically and horizontally and Can use cotton bud to loosen crusting or push out oils
Dont clean inside of eye just outside
How frequently do you do self care management for blepharitis
BD a day and then OD when symptoms have improved
Hows keratitis caused
Minor injury such as foreign body entering eye causing redness around iris
Ear wax symptoms
Impaired hearing
Itchiness
Discomfort/pain
What may cause ear wax
Change of ear wax environment in ear canal
Dust or foreign particles trapped in wax
Ear wax red flags
Tinnitus (ringing in ears)
Persistent pain from within the ear
Unusual discharge from ear canal
War wax management
Ear drops which soften ear wax to aid removal
Syringing/ ear irrigation
Whats micro suction (used in ear wax)?
Ear wax is removed via suction
Whats irrigation (ear wax management)
Using water as a vacuum to remove wax
What risk is carried with micro suction and ear irrigation to remove ear wax
Ear infections risk
What are the different types of ear drops used for ear wax
Water based - sodium bicarbonate
Oil based- olive oil, almond oil, cerumol, earex
Peroxide based- otec, exetrol (urea containing products)
Ear wax counselling
Advise against use of cotton buds
Ideally wax should be cleared naturally
What ear drops would you avoid in a patient with a nut allergy and why
Cerumol - oil based ear drop containing peanuts
Whats otitis externa
Skin infection of outer Ear canal infection that leads into the ear drum (suspect bacterial cause)
Otitis externa symptoms
Itching, pain/discomfort in the ear canal
Watery discharge (due to inflamed skin)
Dry, flakey skin around ear/ along the canal
Otitis externa red flags
Deafness
Persistent pain from ear
Tinnitus
Blocked ears, discharge, bleeding
Nausea, vomiting
<12 years old
What ages would you refer if they presented to you with otitis externa otc
Under 12 years old
Otitis externa medication
Acetic acid 2% (ear calm)
Acetic acid 2% / ear calm OTC age
12 yrs and over
Acetic acid 2% (ear calm) dose for otitis externa
Use until 2 days after symptoms cleared- max 7 day use
Chloramphenicol 0.5% eye drops max day use
5 days
Acetic acid 2% (ear calm) max day use
7 days
Whats audiclean
Audiclean is available otc to clean ears
