OTC - conjunctivitis

Question 1

Symptoms?

Answer 1

BACTERIAL:

• both eyes (one at first)
• sticky, purulent discharge
• redness
• gritty feeling

VIRAL:

• both eyes
• more watery discharge
• redness
• grittiness
• cold/flu symtpoms

ALLERGIC:

• both eyes
• clear and watery discharge
• redness
• itchy feeling
• hayfever/allergic rhinitis

Question 2

Referral criteria?

Answer 2

• true eye pain (not gritty/foreign body-type feeling)
• vision affected (blurred or loss of vision)
• photophobia (sensitivity to light)
• contact lenses (predisposed to keratitis)
• foreign-body in eye
• eye/head trauma
• eye surgery/laser in past 6 months
• eye inflammation associated with rash on scalp/face
• dry eye syndrome

Question 3

Referral eye conditions?

Answer 3

GLAUCOMA

• (acute angle closure)
• sudden, severe eye pain
• n+v
• cloudy eye
• vision (blurred, halos)
• headache

KERATITIS

• (corneal ulcers)
• severe eye pain
• loss of vision
• photophobia
• redness around iris

UVEITIS

• (iritis)
• affects one eye
• irregular shaped pupil
• photophobia
• pupil is unreactive to light

REQUIRE IMMEDIATE REFERRAL = EYE SIGHT LOSS (A+E)

Question 4

OTC product?

Answer 4

FIRST LINE

• 2+ chloramphenicol eye drops
• every 2 hours for first 48 hours then every four hours during waking hours for 5 days
• store in fridge 2-8 degrees

EYE OINT:
- apply 3-4 times daily for 5 days

Question 4

OTC product?

Answer 4

FIRST LINE

• 2+ chloramphenicol eye drops
• every 2 hours for first 48 hours then every four hours during waking hours for 5 days
• store in fridge 2-8 degrees

EYE OINT:
- apply 3-4 times daily for 5 days

• refer if not improving >48 hours
• contraindication: family history of blood dyscrasias, history of myelosuppression with chloramphenicoll use

Question 5

Product spc additional referral criteria?

Answer 5

• glaucoma
• dry eye syndrome
• previous infection in the past
• eye surgery/laser in past 6 months
• current use of other eye drops
• contact lenses
• eye inflammation associated with rash on scalp/face
• new infection occurs during treatment
• conjunctivitis in recent past

Question 6

Chloramphenicol alternative?

Answer 6

• propamidine isetionate (all ages)

Question 7

Advice?

Answer 7

• bathe eyelids with lukewarm water to remove discharge
• throw away tissues used to wipe discharge
• regular hand washing and avoid sharing pillows
• avoid contact lenses during and 24 hours after treatment