Red Eye

Question 1

What three basic steps should you do as a pharmacist to assess someones eye?

Answer 1

1. inspect the eye
2. check for visual acuity
3. Check pupil reactions

Question 2

What is conjunctivitis? What symptoms are mainly associated with it?

Answer 2

inflammation of the conjunctiva

- redness, irritation, grittiness, itching, discharge

Question 3

What questions would you ask a pt if they present with a red eye?

Answer 3

discharge present 
visual changes 
pain/discomfort 
location of the redness 
duration
photophobia
other symptoms

Question 4

What are the symptoms of bacterial conjunctivitis?

Answer 4

• Both eyes are affect but one is often affect first by 24-48 hours
• Discharge is purulent
• Gritting feeling
• Redness is generalised and diffuse

Question 5

What are the symptoms of viral conjunctivitis?

Answer 5

• Both eyes are affected
• watery eyes
• gritty feeling
• generalised redness
• cough and cold symptoms

Question 6

What are the symptoms of allergic conjunctivitis?

Answer 6

• both eyes are affected
• watery
• itching
• generalised redness but greater in fornices
• rhinitis

Question 7

What is subconjunctival haemorrhage? How does it occur?

What tx can be used?

Answer 7

rupture of blood vessel so the whole eye appears red and can be caused by coughing, straining, lifting

no tx, will resolve within 10-14 days

Question 8

What is episcleritis? What would the eye look like?

tx?

Answer 8

inflammation of the sclera
only part of the eye is red - dull ache
no tx, will resolve in 2-3 weeks

Question 9

What is keratitis? Why can it occur?

Answer 9

inflammation of the cornea

administration of long term steroids, soft-contact lenses and trauma

Question 10

What symptoms are present with acute closed angle glaucoma?

Answer 10

unilateral eye pain, headache on the same side as the painful eye, vision blurred, halos, vomiting can occur with the red eye

Question 11

what is scleritis? What symptoms are associated with it?

Answer 11

inflammation of the sclera - comes about if a pt has autoimmune disorders
severe pain especially with eye movement

Question 12

When would you refer a pt with conjunctivitis? (Part1)

Answer 12

painful red eye - true pain 
redness extends to the iris 
photophobia 
vision is affected 
dry eye syndrome 
pt is using eye drops/eye ointments already 
contact lens wearers 
suspected foreign body

Question 13

what general advice would you give pts?

Answer 13

use lukewarm water to remove discharge
tissues used to wipe eyes should be thrown immediately 
avoid wearing contact lenses 
wash hands regularly 
Avoid sharing pillows

Question 14

What tx would you give to someone suffering from allergic conjunctivitis?

Answer 14

sodium cromoglicate, lodoxamide, antazoline, symapthomimetics

Question 15

What tx would you give viral conjunctivitis?

Answer 15

wash avoids etc

Question 16

what tx would you give for bacterial conjunctivitis?

Answer 16

chloramphenicol

propamidine and dibromopropamidine isethionate (brolene)

Question 17

What is the age restrictions and side effects for chloramphenicol and propamidine?

Answer 17

C: >2 years, local burning and stinging
P: >12 years, blurred vision

Question 18

what is the recommended dose used of chloramphenicol eye drops and ointment?

Answer 18

one drop every 2 hours for the first 48 hours then reduce to four times a day for a maximum of 5 days tx

ointment: 1cm of ointment at night tds/qds

Question 19

How often should brolene and golden eye drops be used for?

Answer 19

one or two drops up to QDS
ointment: only at night once or twice daily
no improvement within 2 days - referral

Question 20

When to refer pts with conjuncitvis? (part 2)

Answer 20

pupil looks unusual - glaucoma 
eye looks cloudy 
symptoms persisting more than 2 weeks 
eye surgery/laser tx etc 
no improvement within 48 hours 
cloudy eyes 
foreign body suspected 
pts or family hx of bone marrow problem

Question 21

When to refer? (part 3:

Answer 21

Bf/P
eye inflammation associated with rash on scalp or face 
conjunctivitis in the recent past 
contact lens wearer 
eye or head injury 
pupil looks unusual 
symptoms longer than 2 weeks