PH1122 - Ophthalmology Flashcards
What are instant reasons to refer someone with eye problems ?
All URGENT REFERRAL TO OPTICIANS:
Eye pain
Photophobia
Distortion of vision (changes in visual acuity)
Eye trauma or presence of foreign body
Irregular shaped pupil or abnormal pupil reaction to light
Cloudy cornea with associated vomiting - REFER TO EMERGENCY DEPARTMENT
Any redness that lasts longer than 1 week with the exception of haemorrhage and allergic conjunctivitis
What is the most common type of conjunctivitis ?
Viral conjunctivitis is the most common overall cause of infectious conjunctivitis and usually does not require treatment.
Viral conjunctivitis is often accompanied by other signs of viral respiratory tract infection, such as cough and cold.
How can you dissociate different types of conjunctivitis ?
Viral- Watery, gritty, both eyes, cold and cough symptoms
Bacterial- Purulent discharge, gritty sensation, one eye then usually both
Allergic - Watery, itchy, Rhinitis and both eyes, possible swelling of eyelid
What is the treatment for bacterial conjunctivitis ?
Chloramphenicol eye drops 0.5% every 2 h for the first 24 h and then four 7 times daily
two drops to be applied to the affected eye every three hours.
Do not use for more than 5 days without consulting a doctor.
or chloramphenicol eye ointment 1% can be used over-the-counter (OTC) for the treatment of acute bacterial conjunctivitis in adults and children
aged 2 years or over. Symptoms usually settle in a few days. Five days treatment
What is treatment for allergic conjunctivitis ?
Sodium chromoglicate
The dose is one or two drops administered in each eye four times a day for children aged 6 years of age and older.
Oral antihistamines
and possibly cold compresses to reduce swelling
What is the treatment for viral conjunctivitis ?
Currently, there are no specific over-the-counter (OTC) preparations available to treat viral conjunctivitis. However, symptoms may be eased by bathing the eyelids to remove any discharge and using lubricant eye drops. Viral causes are highly contagious, and the pharmacist should instruct the patient to follow strict hygiene measures
what are some characteristic symptoms of blepharitis ?
inflamed eyelids, itchy, stinging and sticky eyes.
tends to be chronic
what advise should be given to someone with blepharitis ?
soak the eyes with a warm cotton wool or flannel
clean the eye-lids with a wet cloth with cleanser.
sometimes topical antibiotics are used for flare-ups of the condition, and long- term treatment is often needed (6 weeks or more). Although pharmacists can advise and support patients who have this common condition, confirmation of the diagnosis and initiation of treatment is best done by the optometrist or at the GP surgery.
What is the treatment for dry eyes ?
• For people with mild or moderate symptoms, artificial tears alone are usually sufficient.
o Hypromellose is the most commonly used product but requires frequent
administration (ideally 30-min intervals initially until symptoms improve,
then decreased frequency).
o Products containing carbomers or polyvinyl alcohol require less frequent
application but may be less well tolerated.
o Sodium chloride (saline) is short acting and suitable as ‘comfort drops’ or
for use with contact lenses.
o If a product causes irritation or if soft contact lenses are worn, con-
sider switching to one that is preservative-free – hypromellose, carbomers, polyvinyl alcohol, sodium chloride, carmellose sodium, hydroxyethylcellu- lose and sodium hyaluronate are available without preservatives.
o The preservative that most often causes eye irritation is benzalkonium chloride.
o If more than six applications are used daily, consider using a preservative- free product as the risk of irritation from the preservative increases with the frequency of dosing.
Eye ointments containing paraffin may be uncomfortable and blur vision, so they should usually only be used at night and never with contact lenses.
What are the symptoms of a haemorrhage in the eye ?
very common cause of a red eye. It is caused by a small bleed behind the membrane layer of the conjunctiva and results in redness over the white of the eye
how would you treat a haemorrhage in the eye?
It should clear on its own within 1-2 weeks
Refer if high blood pressure is suspected or if they have unexplained bleeding or bruising somewhere else.
