Pharmaceutical care of Ocular Conditions Flashcards
Who do you refer?
Babies >2 years
Babies with sicky eyes from birth
Patients undergone ophthalmic/laser surgery
What are the 5 symptoms to look for?
5 P’s
Pain
Photosensitivity
Pupils
Problems
Pus
What are the possible causes of red eye?
Conjunctivitis
Subconjunctival haemorrhage
Inflamed
What are the different types of conjunctivitis?
Viral
Bacterial
Allergic
What should you do for allergic conjunctivitis?
Resolve within 7-10 days once exposure has stopped
What should you do for bacterial conjunctivitis?
Resolves within 7-10 days
Can give chloramphenicol
What is the course for chloramphenicol?
MAX 5 days
BUT take for 2 days after symptoms
What can chloramphenicol also do?
Help loosen hardened discharge on lids
What are the antiseptics available?
Propamidine isetionate drops
Dibromopropamidine isetionate eye ointment
What is the antibacterial available?
Chloramphenicol drops + ointment
What is chloramphenicol?
Topical treatment of acute bacterial conjunctivitis in adults + children over 2
What must contact lens users do whilst using chloramphenicol?
Stop using them
What is the dose regime for chloramphenicol?
1 drop every 2hrs for first 48hrs
And every 4hrs thereafter
Ointment = 3-4x/day
When do you refer to GP with chloramphenicol?
If no improvement within 48hrs
What must you do with chloramphenicol after 5 days?
THROW IT AWAY
What is the eye hygiene for conjunctivitis chloramphenicol?
Don’t touch eye/lashes with nozzle
Wash hands
Don’t share bottle with anyone
What are the side effects of chloramphenicol?
Transient stinging/burning
Blurred vision
What does chlamydial conjunctivitis require?
Urgent referral
How do you treat allergic conjunctivitis?
Avoid/minimise exposure to trigger
Oral histamines
Cold compress for eyes
Sodium cromoglicate (long-term)
When do you refer someone with subconjunctival haemorrhage?
If on warfarin
How do you treat subconjunctival haemorrhage?
Resolves spontaneously 7-14 days
What are the cause of inflamed eyes?
Tired/irritated
Overworking
Over-exposure to smoky/dusty air
What is the treatment for inflamed eyes?
Eye lotions/drops
What is the treatment for styes?
Apply hot compress
Refer if not resolved within 7 days
May remove eyelash
What is the treatment for chalazion?
Resolve spontaneously
Treat same as styes
May require surgery to drain
What is marginal blepharitis?
Inflammation of margin of eyelid
What is the treatment for marginal blepharitis?
Lid hygiene
Contact lenses not worn
What are included in lid hygiene?
Warm compress
Massage eyelid
Clean eyelid 2x a day
Lid wipes
Stop with eye makeup
What can be used to treat bacterial blepharitis?
Antibacterial ointment rubbed into eyelashes 2-3x/day for 7 days
Systemic = oral antibiotics
What may cause watering eyes?
Interrupted drainage of tear film due to blockage of nasolacrimal duct
What can watering eye be a symptom of?
Dry eyes
What is watering eye often as a result of in older people?
Ectropion/entropion conditions
How do you treat dry eye?
Eye drops with preservative
Preservative free eye drops
What is the problem with preservatives?
Can cause eye irritation
= NOT to be used more than 4x/day
What can early cataracts cause?
Myopic shift = see optometrist to change glasses prescription
What may be used to treat glaucoma?
Parasympathomimetic drops
Sympathomimetic drops
Beta-blockers
Prostaglandins analogues + prostamides
Carbonic anhydrase inhibitors
What is the screening for glaucoma?
Diabetics
>40 years
1st degree relatives of glaucoma
What is diabetic retinopathy?
Damage to retina due to increased sugar in eye
How is the proliferative stage of diabetic retinopathy treated?
With surgery
= scatter laser to shrink abnormal blood vessels
What are eye drop dispensers suitable for?
People with impaired sight/shaky hands
How is macular oedema treated?
With focal laser treatment
How often does patients >40 with a family history of glaucoma/ocular hypertension who are not part of a monitoring scheme?
Every year
How often does patients with diabetes who are not part of a diabetic retinopathy monitoring scheme?
Every year
Describe rigid gas permeable contact lens
Smaller
Take longer to get used to
More durable
Describe soft contact lens
Larger + cover cornea
Replacement daily
Daily-wear
Incorporate water to stop drying out
What is involved soft contact lens care?
Daily cleaning
Disinfection
Protein removal
What is involved in hard contact lens care?
Wetting solutions
Describe contact lens care for all
Reduction in tear flow = lens discomfort
Lens intolerance = hormone preparations
Lens discolouration = sulfasalazine
When are you advised not to wear contact lens?
Dry eyes
Blurred vision
Cold sores
Eye infections
