Eye Disorders

Question 1

In what situations would a patient require URGENT referral to physician or ER?

Answer 1

pain
photophobia
any disturbance of vision
blurred vision
blunt trauma
chemical exposure
embedded foreign body
heat exposure (i.e., welder arc aka flash burn, sunburn of cornea)
eye protrusion

Question 2

A patient comes to the pharmacy with red eye and/or bacterial conjunctivitis (possibly, since there is purulent discharge). When would you REFER to a doctor?

Answer 2

1. if no improvement with OTC within 48 hours
2. if its a child
3. wears contact lenses + red irritated eye
4. Red eye + rheumatoid arthritis or diabetes

Question 3

What is an OTC option for red eye?

Answer 3

polysporin - polymyxin B/Gramicidin instill QID for 7-10 days (schedule III)

Question 4

A patient comes to the pharmacy with watery eyes due to seasonal allergic conjunctivitis. When would you REFER to a doctor?

Answer 4

• if no improvement within 72 hours
• children < 12 y/o

Question 5

OTC options for seasonal allergic conjunctivitis

Answer 5

topical decongestants (ex. oxymetazoline) eye drops

lubricant eye drops

duration: 3-4 days

Question 6

When would you recommend OTC eye drops that are preservative-free?

Answer 6

if eye irritation

Question 7

should oxymetazoline eye drops be used > 3 days?

Answer 7

no, it can cause hyperemia (red eye)

Question 8

drug interactions with oxymetazoline

Answer 8

MAOi - interacts with oxymetazoline nasal spray (cat X), topical (Cat B), but no interaction with eye drops

TCA + oxymetazoline nasal = CAT. C

SSRI and SNRIs do not interact with oxymetazoline

Question 9

OTC options for viral conjunctivitis

Answer 9

lubricant eye drops (preservative free) if eye irritation

Question 10

When to refer for Blepharitis? (itchy, red, scaly and sticky eye lids)

Answer 10

if new onset is suspected, refer. can also refer for possible associated acne, rosacea or seborhreic dermatitis

Question 11

non pharms to suggest to patients presenting with blepharitis

Answer 11

eye hygiene - warm compress to loosen crust, eye scrubbers

Question 12

a patient presents to the pharmacy with a stye. what would you recommend?

Answer 12

1. see the doctor if it doesn’t drain within 48 hours
2. warm compress at home

Question 13

patient presents with eye pain. what would you recommend?

Answer 13

refer to dr

Question 14

patient presents with dry eye (gritty, sandy) and has diabetes. what would you recommend?

Answer 14

refer to dr

Question 15

patient presents with blurred vision. what would you recommend?

Answer 15

refer to dr

Question 16

patient presents with eye pain due to a foreign object. what would you recommend?

Answer 16

refer to dr

Question 17

patient presents with dry eye symptoms. he has no medical conditions. what would you recommend?

Answer 17

OTC eye lubricant/artificial tears