RTS - eyes

Question 1

Treatment options for bacterial conjunctivitis (& dosage)

Answer 1

Antibiotics - chloramphenicol drops or ointments -5 days treatment .
first 2 days - 1-2 drops every 2 hours
remaining 3 days - 4 times a day

(ointment) -
apply 4 times a day for 5 days

Question 2

What do antibiotic eye drops do?

Answer 2

Stop the growth of bacteria on the surface of the eye

Question 3

What is:

• The brand of antibiotic eye drops
• Storage instructions
• Licensing

Answer 3

Optrex
store in fridge
licensed for people above age of 2

Question 4

What are alternative treatment options for bacterial conjunctivitis?

Answer 4

Propamidine drops (brolene or golden eye)

Question 5

when should bacterial eye drops not be used?

Answer 5

• In people who permanently wear contact lenses
• Blood dycrasias
• taking medicines affecting bone marrow

Question 6

What is advice for people who wear contact lenses on taking antibiotic eye drops?

Answer 6

remove contacts during treatment and wait 24 hours after ending treatment to put back in

Question 7

What are treatment options for allergic conjunctivitis?

Answer 7

Topical mast cell stabiliser sodium cromoglicate eye drops (BRAND = OPTICROM)

Question 8

Why are eye drops better for allergic conjunctivitis?

Answer 8

they stop the release of histamine in mast cells

Question 9

what is the dosage and licensing for allergic eye drops

Answer 9

use in patients >12 years and up to 4 times a day when required

Question 10

Give examples of antihistamine eye drops for allergic conjunctivitis and what they do

Answer 10

Antazoline / Xylometazoline (e.g. otrivine - antistin) - sympathomimetic - act lik decongestents to dry up secretions

Question 11

how long can antihistamine eye drops be used for and license?

Answer 11

5 days

licensed for >5 years old

Question 12

What are treatment options for viral conjunctivitis?

Answer 12

No specific treatment - supportive therapies e.g hot/cold compress, eye drops for symptoms

Question 13

Give examples of treatments for specific symptoms of viral conjunctivitis

Answer 13

• Decongestants to reduce surface swelling
• antihistamines reduce itching
• vasoconstrictors to whiten the eye

Question 14

What are the symptoms of bacterial conjunctivitis? (6)

Answer 14

• one/both eyes- one eye first
• sticky, yellow/green
• gritty, sore, uncomfortable
• generalised & diffused redness
• no other symptoms
• 2-3 days it lasts

Question 15

Symptoms of viral conjunctivitis? (6)

Answer 15

Both eyes

• Watery discharge
• gritty, uncomfortable
• generalised redness
• Cough & cold symptoms aswell
• 1-2 weeks

Question 16

Symptoms of allergic conjunctivitis? (6)

Answer 16

• both eyes
• clear watery discharge
• itching
• generalised redness
• associated with - allergic rhinitis, eczema, asthma, sensitivity to light
• variable duration

Question 17

Lifestyle advice for conjunctivitis

Answer 17

wash hands
bathe eyelids with warm water to remove discharge
clean eye - wipe from bridge of nose to outer corner with fresh piece of cotton wool
protect eyes from wind and sun via sunglasses (if its allergic)

DONT - share towels, pillows etc. Don’t rub eyes and don’t wear contact lenses until it has gone.

Question 18

what is the expiry date for eye drops?

Answer 18

one month 28 days after opening

Question 19

can chloramphenicol be sold to pregnant women?

Answer 19

No - must refer

Question 20

What medicines can cause dry eyes?

Answer 20

antihistamines

diuretics

Question 21

General red flags for eyes

Answer 21

pain in eye
visual disturbance
pupils look unusual 
treatment failure 
upper eyelid dropping
contact lense wearers if drops are unsuitable
eye or head injury 
photophobia

Question 22

what are other eye problems aside from conjunctivitis?

Answer 22

Dry eyes - tear deficiency causing discomfort
Macular degeneration - macula can’t function as effectively
Blepharitis - inflammation of eyelid margins
Stye - red painful lump on eyelid
Subconjunctival haemorrhage - burst blood vessel
Cataract - sense of eye become opaque

Question 23

Treatments for dry eyes - artificial tears

Answer 23

Hypromellose
carmellose
carbomer 
acetyl cysteine 
polyvinyl alcohol 
paraffin bases

Question 24

Treatment for blepharitis

Answer 24

1st line - wash eyelids wth diluted baby shampoo - one part shampoo, 10 parts water
Warm compress may help to loosen crusts
Antibiotics may be needed

Question 25

treatment for stye

Answer 25

Goes away on its own within 7-14 days but can use a warm compress - put on eye for 5 mins, 3-4 times daily until it drains
DO NOT try and puncture it

Question 26

How do you apply eye drops?

Answer 26

wash hands
pull down lower eye lid with index finger to make pocket & tilt head back
Put the bottle between thumb and index finger and insert 1 drop into the eye
Don’t touch the eye with the dropper tip and don’t blink, close the eye and press gently over the corner to stop the drops going into tear duct