Eyes

Question 1

What is conjunctivitis?

Answer 1

Inflammation of conjunctiva due to allergy or infection

Question 2

What are the causes and symptoms of allergic conjunctivitis?

Answer 2

Hay fever or allergens e.g. eye cosmetics, eye drop ingredients
Symptoms include red eye, watery discharge, itchy, usually both eyes affected, possible other systemic sympoms

Question 3

What is the treatment of allergic conjunctivitis?

Answer 3

Mast cell stabiliser eye drops e.g. sodium cromoglicate- Opticrom allergy
Antihistamine/decongestant drops e.g. antazoline/ xylometazoline- Otrivine antistin
POM treatments- mast cell stabilisers, antihistamines, short term topical steroids

Question 4

What are the causes and symptoms of infective conjunctivitis?

Answer 4

Bacterial or viral infection
Symptoms include red eye, discharge (viral- watery, bacterial- sticky, purulent), usually starts in one eye then spreads to the other, slightly painful gritty sensation, vision unaffected, viral may be associated with other upper RTI symptoms

Question 5

What is the treatment for bacterial conjunctivitis?

Answer 5

Antibacterial eye drops/ointments e.g. propamidine- Golden eye, Brolene
Chloramphenicol e.g. Optrex infected eyes, golden eyes antibiotic; for acute bacterial conjunctivitis in over 2s as a course of five days, store in fridge
GP in 48 hrs if no improvement/symptoms worsen

Question 6

What is the treatment for viral conjunctivitis?

Answer 6

Usually self limiting but antibacterial drops will prevent secondary infection

Question 7

What is a sub-conjunctival haemorrhage?

Answer 7

Burst blood vessel (looks worse than it is)

Question 8

What are the symptoms and treatment of a sub-conjunctival haemorrhage?

Answer 8

Red eye, no pain, spontaneous event

No treatment required as will heal spontaneously

Question 9

What are the symptoms and causes of inflamed/tired eye?

Answer 9

Regular rubbing of eyes
Rims of eyes red/bloodshot
Irritation
Causes: overexposure to smoke, driving, working at VDU

Question 10

What is the treatment for inflamed/tired eye?

Answer 10

Witch hazel- astringent, anti-inflammatory properties e.g. Optrex eye wash, Optrex sore eyes
Vasoconstrictors shrink dilated blood vessels which cause redness, naphazoline e.g. Optrex bloodshot eyes, Murine irritation and redness relief eye drops

Question 11

What is dry eye?

Answer 11

Deficiency of the conjunctival mucus or a tear deficiency leading to dry, irritated eyes

Question 12

What are the causes of dry eye?

Answer 12

Age, environment, medication e.g. tricyclic antidepressants, lack of blinking, contact lenses, changes in hormone levels, systemic diseases e.g. rheumatoid arthritis

Question 13

When should dry eye be referred?

Answer 13

Associated disease e.g. Sjogren’s syndrome, children, diabetics, history of trauma to eyes, cause is not obvious or is complex, suspected ADR (treat in meantime), if symptoms have not responded to OTC treatment

Question 14

What is the treatment for dry eye?

Answer 14

Advise to avoid causative factors
Artificial tears eye drops e.g. hypromellose, polyvinyl alcohol, sodium hyaluronate
Artificial tears eye gels e.g. Carbomer 980
Hydrophobic ocular lubricants e.g. lacrilube
Dry eyes spray

Question 15

Why should a blunt injury to the eye always be referred?

Answer 15

May cause increase in pressure, detachment of retina or corneal scarring

Question 16

Other eye conditions that need referring

Answer 16

Glaucoma
Iritis (pain in eye, red, pupil small)
Corneal ulcer (main symptom is pain)

Question 17

What is a stye?

Answer 17

Inflammation of the margin of one eyelid, caused by infection of the hair follicle gland at the base of an eyelid

Question 18

What are the symptoms of a stye?

Answer 18

Irritation, tender but no real pain, red swelling by base of eyelash

Question 19

What is the treatment for a stye?

Answer 19

Should resolve by itself
Can use hot compress to aid discharge
Prevent spreading using Golden eye ointment or Brolene eye ointment
Refer if severe

Question 20

What is blepharitis?

Answer 20

Chronic condition- redness/irritation of the eyelid margins
Scales can adhere to the base of the eyelid
Can be associated with seborrhoeic dermatitis or dandruff

Question 21

What is the treatment for blepharitis?

Answer 21

Keep eyes clean
Treat infection
Replace tears
Hydrophobic ocular lubricants can be used to soften crusts e.g. lacrilube

Question 22

What is ectropion?

Answer 22

Eyelids turn out, tears roll down face
Can be damage to tear film
Refer

Question 23

What is entropion?

Answer 23

Eyelids invert, lashes point inwards, can irritate/scar eyes, need lubrication/surgery
Refer

Question 24

What is a chalazion?

Answer 24

Hard pea like lump under the skin of the eyelids
Granuloma of meibomian gland, leads to blocked duct, leads to accumulation of fluid, also known as Meibomian cyst
Should resolve spontaneously
Refer if persistent/recurrent

Question 25

What is ptosis?

Answer 25

Dropping of upper eyelid(s)
Often a sign of systemic disease
Refer

Question 26

General referral criteria

Answer 26

Pain
Changes in vision
Severe or persistent symptoms
Symptoms indicate injury or systemic condition
Non-response to antibacterial treatment (2 days)
Cannot be treated OTC

Question 27

Use of ophthalmic preparations

Answer 27

Good hygiene
Potential problems with contact lenses- don’t wear soft contact lenses while receiving treatment as constituents can adhere to or abord into them
Expiry dates