Eye and Ear problems Flashcards
What questions should be asked regarding the eye?
- Is vision affected
- Any family history of eye complaints e.g glaucoma
- Severity and type of discomfort if any (itchy treat or STABBING REFER)
- Ask about discharge (EXAMIN EYE)
- Previous eye history - contacts, had issues before
- Anything in the eye
What are the steps in an eye examination?
- Inform about examination
- Gain consent
- Wash hands
- Sit down and look straight ahead
- Pull down lower lid and ask to look up, down, left, right (foreign objects?)
- Check reaction to light and pupil size and shape
- Check visual acuity by getting to read small print
- Both eyes
- Wash hands
On inspection, a patients eye had thick, purulent discharge and generalised redness.
They say it feels gritty.
They have no other symptoms.
What is the likely cause?
- Bacterial conjunctivitis
- Thick purulent discharge
- Gritty feeling
- No other symptoms
- Generalised and diffused redness
One eye usually affected before other
What are the red flag/referral symptoms that could come with conjunctivitis?
- Clouding of cornea (black of eye)
- Distortion of vision
- Irregular shape pupil
- Photophobia
- Foreign body
- Contact lenses (can’t use chloramphenicol)
- Vomiting
- ## True eye pain
What are the symptoms of allergic conjunctivitis?
What treatment can be suggested?
- Watery discharge
- Itchy sensation
- Generalised redness but greatest in fornices
- Associated rhinitis (nasal inflamm)
- SEASONAL
- ANIMALS?
- Do you suffer from hay fever?
- OPTICROM dye drops
- Wrap around sunglasses
- Hayfever measures
What are the symptoms of viral conjunctivitis?
- Watery discharge
- Generalised redness
- Associated cough and cold
How long should Chloramphenicol drops/ointment be used for?
When should drops/ointment be used
Any other advice?
- 5 days minimum
- Drops daytime, ointment at night as thicker
- Keep in the fridge when not using
- Dispose of drops after treatment
A patient presents with dry, gritty eyes.
What should you do?
- Ask how long been suffering
- Ask to take a look
- Ask if anything known might be causing issue (something in eye, air conditioning, staring at screen)
- Ask if any other medical conditions e.g sjogrens, bells palsy
- Ask if dry secretions in mouth too? SJOGRENS
- Ask if taking other meds e.g TCA’s dry secretions
- ASK AGE - sometimes older = eyes dry
- Ask if taken anything before?
- Contact lenses user?
- Suggest drops
- Use PRN
- Can use thicker Carbomer 940/geltears - night
A patient comes into your pharmacy really concerned about their eye.
They felt a pop like feeling and now their eye is extremely red and appears to be bleeding
What should you do?
- Examine the eye
- Ensure redness is not on the iris
- Check to see if they are on any medication
- If on Warfarin then refer
- Say that it is nothing to worry about it no other symptoms
- If it doesn’t get better within a week then see optometrist
A patient comes into your pharmacy with a spider like redness on their eye
What should you do?
- Examine the eye
- Ask if any other symptoms e.g pain, photophobia, loss of visual acuity, watery discharge RULE OUT SCLERITIS
- If no then could be episcleritis
- Advise that this should resolve but if gets worse or no better within a week then see optometrist
What is keratitis?
What should happen if a patient is suspected of having it?
- Inflammation of the cornea as a result of trauma
- Long term steroid eye drops/contact lenses
- Redness around iris
- Painful
- Watery discharge
- Photophobia
- Open lesion on eye
- REFER THIS
On examination, a patients pupil appears jagged.
They also have photophobia, watery discharge and redness of the eye.
What do you suggest?
- Could be uveitis
- Caused by inflammation of uveal tract
- Refer to optometrist to rule it out
What are the symptoms of glaucoma?
What should happen if a patient is suspected of having it?
- Cloudy pupil
- Pain
- Loss of vision
- Vomiting
- Family history
- Elderly
- Loss of visual acuity
- INCREASED OCULAR PRESSURE AND INC IN AQ HUMOUR
REFER TO A AND E!
A patient comes in with a swollen upper eye lid.
It is painful to touch
It is only affecting one eye
What do you recommend?
- On inspection it looks like a stye
- They are self limiting and will go away with time
- No OTC products will help
- Can recommend a warm compress to be applied 3-4 times daily to bring the stye to a head
- DO NOT TRY AND POP A STYE
- If it gets worse or persists and you are concerned then see you optometrist
A patient presents with eyelids that are irritated, itching and they say they are burning.
- The skin around the eyelashes is flaking and some lashes are missing
What do you advise?
- Check for referral symptoms
- Have they had it before?
- Sounds like blepharitis
- No OTC products are especially helpful
- Suggest using a mild baby shampoo diluted in recently boiled and cooled water on cotton wool balls to bathe the eyelids and to moisturise the flaky areas
- Apply a warm compress a few times a day to soothe the itching
- AVOID MAKE UP
- See optometrist if the problem does not improve within a week or begins to worsen
