Eye disorders - OSCE

• focal swelling

• pain, redness, irritation

• warm water compress for 10-20 mins tds-qid

• can be external or internal

• caused by infection of the hair follicle

Stye

• blockage in the eye lid

• painless

• lump

• non-infectious

• self -limiting

• lubricants/warm compress

Chalazion

• inflammation of eye lid margin

• crusting of eye lid or scales

• tearing

• red and swollen

• itchy burning

• warm compress daily for 2-5 mins to soften crust

• gentle scrub of lashes with NaHCO3 and baby shampoo solution

• unresponsive - refer

• Chloramphenciol - 1% - bd 1-2 weeks

• Opti-soothe, Systane, Clear eye

• new pad, inner corner to outer

Blepharitis

• tearing

• evaporation

• environment, aging, medication, medical conditons, contact lenses, parkinsons

• dry, burining, irritatd, tired, excessive tearing

• avoid triggers

• lubricants

• refer to eye doctor is no improvement after 2-4weeks

dry eye

• reduce tear secretion

• increases risk for preservative toxicity

eye drops/ gels

• use overnight - can blur vision

eye ointments

• spray onto close eye lids - 10cm away

• phospholipid liposomes - stabilise lipid layer of tear film to reduce tear evaporation

eye sprays

• seasonal - pollen grass

• animal dander, dust mites

• eye drop preservatives

• itchy, clear discharge, redness, nasal discharge

• Antihistamines (reduce allergy effect)- Levocabastine - (adult, above 6) - 1 drop both eyes bd-qid

• drowsiness, stinging on installation

allergic conjunctivitis

• Cromo-fresh - 1 drop both eyes 4-6 times daily

• Lodomide - (adult, above 4) - 1 drop both eyes qid

• stinging and burning

Mast cell - stabilisers - allergic conj

• Eyezep - (adult, above 4 years) - 1 drop both eyes bd-qid - bitter taste

• Zaditen - (adult, above 3 years) - 1 drop eye bd - stinging, eye irritation, headache, sedation

Antihistamine - Mast Cell stabilsiers

• caused by flu, pneumonia

• sel-limiting (2-5 days)

• redness, yellow discharge, crusting, grittness

• can be bilateral

• Chorsig - 1-2 drops into affected eyes every 2 hrs while awake for 1st day, if improvement 1 drop every 6 hrs up to 7 days

• stinging, allergy

• continue for up to 2 days after symptoms are reduced

• refer after 48hrs if no improvement

• Chorsig ointment - bedtime or every 3 hrs

Bacterial Conjuctivitis

• caused by adenoviruses

• upper respiratory infections

• spontaneous resolution - 2-4 weeks

• red eyes, watery discharge, gritty, can be bilateral

• cold compress, lubricant

• hygiene - stop spread

Viral conjunctivtis

• rupture of blood vessel

• caused by sneezing

• no treatment

• resolves - 10-14 days

Subconjuctival Haemorrhage

• unilateral

• localised patch of redness

• painless or dull ache

• self limiting

Episcleritis

• true eye pain

• blurred vision or reduced

• photophobia

• vomiting

• allergic reaction to eye drops

• injury or foreign body

• OTC failure

Referral symptoms

• discard after 28 days

storage for eye products