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2017 HCHB_digital

Eye Conditions

Eye Conditions (continued) Type Symptoms Advice for customers Treatment options AGE-RELATED MACULAR DEGENERATION (AMD) BACTERIAL CONJUNCTIVITIS ALLERGIC CONJUNCTIVITIS VIRAL CONJUNCTIVITIS Loss of vision or blurred area near the center of vision in one or both eyes. Vision loss may occur gradually, or suddenly. Blurred area may become larger or blank spots may develop in the central vision. Loss of vision may interfere with everyday activities. Objects may not appear as sharp or bright as they used to be. AMD is common and the leading cause of vision loss among people over the age of 50. Symptoms are red, burning, sore eyes often with puffy eyelids and a thick white/yellow discharge. Eyelids may be stuck together on awakening. Symptoms come on suddenly and both eyes are usually infected (it is very contagious), although one eye may be affected a day or so before the other. Symptoms usually resolve themselves within about one to two weeks. Antibacterial eye drops may hasten recovery by a couple of days. Symptoms include very itchy, burning, sore red eyes with puffy eyelids and maybe dark pouches below the eyes, and clear, copious discharge that may be watery or sticky. There is often a history of other allergic symptoms, eg, sneezing and runny or congested nose (see Hay Fever). Symptoms are red, sore and gritty eyes with a clear watery discharge. Some itching and swelling may be present, with some crusting on the eyelids. One or both eyes may be infected. Frequently caused by the common cold virus or adenoviruses; other viral symptoms may also be present (eg, fever, sore throat). Symptoms may last two to three weeks. If herpes simplex is involved, there will be no other viral symptoms but there may be cold sores elsewhere (see Cold Sores). Refer to a doctor immediately as herpes simplex can cause scarring and perforation of the cornea. AMD is more common in people over the age of 50, in caucasians compared with African-Americans or Hispanics/Latinos and in people with a family history of AMD. Stop smoking if you smoke; smoking doubles the risk of AMD. Exercise regularly, keep blood pressure and cholesterol under control, and eat a diet rich in green, leafy vegetables and fish. Get a comprehensive dilated eye exam at least once a year. Bathe eyelids with warm water or saline solution and use warm compresses. Soak cloth in nappy solution and wash thoroughly after each use. Do not share face cloths, towels or eye drops. Dispose of tissues carefully. Do not use a decongestant eye drop as it can mask the redness and thereby mask worsening infection. Wash hands frequently and after any contact with the eyes. Apply a cold flannel to soothe the eyes. Avoid triggers (eg, pollen, animal dander) where possible. Wash hands frequently and after any contact with the eyes. Combination eye drops containing decongestants should not be used for more than three days, to avoid rebound congestion in the eyes. Viral conjunctivitis is contagious so do not share face cloths, towels or eye drops. Dispose of tissues carefully. Wash hands frequently and after any contact with the eyes. If symptoms do not improve or get worse seek medical advice. Consider taking supplements shown in trials to reduce the risk of late AMD by 25%. Known as AREDS and AREDS2 these substances contained clinically effective dosages of vitamin C. vitamin E, zinc oxide, cupric oxide, and beta-carotene, lutein, or zeaxanthin. [GENERAL SALE] eg, Macu-Vision Blackmores* (contains ascorbic acid, cupric oxide, zinc oxide, vitamin E) Bacterial conjunctivitis can be treated with antibacterial/ antibiotic eye drops. Consider using single-use wipes to keep eyes clean. Hypoallergenic pH-balanced wipes eg, Clear Eyes, Fess Antibacterial eye drops [PHARMACY ONLY MEDICINE] eg, propamidine isethionate (Brolene Eye Drops*) [PHARMACIST ONLY MEDICINES] eg, Chloramphenicol eye drops 0.5% (Chlorafast), Chloramphenicol eye ointment 1% (Chlorsig) Treat with antihistamine tablets or eye drops (see Hay Fever). Hypoallergenic pH-balanced wipes eg, Clear Eyes, Fess Mast cell stabilisers (eye drops) [PHARMACY ONLY MEDICINE] eg, cromoglycate (Cromo-Fresh), lodoxamide (Lomide) Preventive medicines used four times daily on an ongoing basis. Antihistamines (eye drops) [PHARMACY ONLY MEDICINE] eg, levocabastine (Livostin), ketotifen (Zaditen) Decongestant combinations (eye drops) [PHARMACY ONLY MEDICINE] eg, naphazoline (+ antazoline: Albalon A Allergy; + pheniramine: Visine Allergy; + zinc: Clear Eyes Allergy) There are no OTC preparations available to treat viral conjunctivitis. Treat symptomatically using soothing lubricant eye drops and bathing the eyes. Consider using single-use wipes to keep eyes clean. Hypoallergenic pH-balanced wipes eg, Clear Eyes Wipes, Fess Little Eyes Wipes [GENERAL SALE] eg, Celluvisc Drops (PF) , Clear Eyes-D, Clear Eyes Eye Mist Spray (PF) , Hylo-Fresh* (PF) , GenTeal (PF) , Optive, Optrex Actimist 2 in1 Tired & Uncomfortable Eye Spray,Refresh Plus (PF) , Refresh Tears Plus, Refresh Liquigel, Systane Products with an asterisk have a detailed listing in the Eye Conditions section of OTC Products, starting on page 235-237. READY, SET, LEARN! Page 66 HEALTHCARE HANDBOOK 2017-2018 Common Disorders

CONTINUING OTC EDUCATION Type Symptoms Advice for customers Treatment options MINOR EYE IRRITATIONS RED EYES DRY EYES BLEPHARITIS STYES PF = Preservative-free Symptoms are red, sore, watering eyes, with or without itch. Causes are numerous, including allergies, late nights (“party eyes”), wind, dust, smoke, air conditioning, air pollution, chemicals, sunlamps, glare (snow, sand, sun, sea), staring at a computer. A patch of bright red in the whites of the eye is called a subconjunctival haemorrhage. It usually causes no pain and is self-limiting, clearing in about one week. Symptoms are dry and gritty eyes (feels like sand in the eye). Caused by an imbalance in the tear film that lubricates the eye between blinks so may also cause eyes to water as tear film now ineffective for lubrication. Eyes may look slightly pink or have a fine crusting on the lids. Contact lenses may not sit properly on the eye. Caused by ageing, contact lens wear, hormone fluctuations (eg, with menopause, oral contraceptive use, pregnancy), medical conditions (eg, rheumatoid arthritis), irritants (eg, smoke, dust, wind), surgery, trauma, and certain medicines (eg, diuretics, antihistamines, decongestants and tricyclic antidepressants). Symptoms include inflammation of the eyelids, with crusting or scales at lid margins. The eyelids are usually red, thickened, burning, sore and feel itchy, and may be stuck together in the mornings. There may be photophobia (sensitivity to light). The condition is often chronic and tends to be associated with dandruff and/or dry eye. A stye is an infected gland at the base of an eyelash. Symptoms include a localised painful, swelling in the upper or lower edge of the eyelid, which is sensitive to touch. The eyes may water and be sensitive to light. A person with a stye may report feeling as if they have a foreign body in the eye. Most styes resolve spontaneously. Allergy is a common cause of red eye (see allergic conjunctivitis previous page). Avoid the cause if possible. Eye drops containing decongestants should not be used for more than three days, to avoid rebound congestion in the eyes. Treat cause if possible and keep wellhydrated. Damage to the eyes can occur if left untreated for too long, as the cornea can easily get scratched. Protect eyes from the wind and wear sunglasses when outside. Use an eye wash to soothe sore, irritated and tired eyes. Use lubricant eye drops (artificial tears) during day and lubricant eye ointment at night. Throw multi-use eye drops away one month after opening unless otherwise stated. Consider using preservative-free eye drops long term as sensitivities can develop with regular use of preservative-containing drops. Daily eyelid hygiene is important for control. Baby shampoo (not soap) may be used to make an effective eyelid wash solution. Put about half a teaspoon of baby shampoo into a bowl of hot, not boiling, water. Wet a clean cloth with the solution. Place the cloth over the eyes as a compress for two minutes. Clean around the eyelashes gently, using a cotton bud dipped in the hot baby shampoo solution. Undertake this treatment twice a day, then less often as the blepharitis settles. Rinse the cloth first in nappy wash solution and then fresh water before use to avoid bacterial contamination of the cloth. Treat any dandruff (see Dandruff). Most styes resolve themselves when they rupture and pus is released. Warm-to-hot (but NOT boiling) compresses, using a clean cloth applied three to six times daily, can hasten the “pointing” of the stye. Avoid touching the stye, or squeezing it, or using make-up near it. Treat minor eye irritations with lubricants or decongestant eye drops. Lubricant eye drops/eye spray [GENERAL SALE] eg, Celluvisc (PF) , Clear Eyes Eye Mist Spray (PF) , GenTeal (PF , Hylo- Fresh (PF , Optrex ActiMist 2 in 1 for Dry & irritated Eyes, Optrex Actimist 2 in1 Itchy & Watery Eye Spray, Refresh Plus (PF) , Systane Decongestant eye drops [PHARMACY ONLY MEDICINE] eg, Albalon A Allergy (with antihistamine), Albalon Relief (PF) , Albalon, Clear Eyes, Clear Eyes Allergy, Optrex Red Eyes Eye Drops*, Visine Clear, Visine Advanced Eye wash [GENERAL SALE] eg, Optrex Eye Wash with Eye Bath Lubricant eye products do not cure dry eyes but mimic the effect of natural tears so can relieve the symptoms. Regular eye washes may help improve symptoms. Eye wash [GENERAL SALE] eg, Optrex Eye Wash with Eye Bath* Lubricant eye drops/eye spray [GENERAL SALE] eg, Celluvisc Drops (PF) , Clear Eyes-D, Clear Eyes Eye Mist Spray (PF) , Hylo-Fresh* (PF) , GenTeal (PF) , Optive, Optrex Actimist 2 in1 Dry & Irritated Eye Spray, Optrex Actimist 2 in1 Itchy & Watery Eye Spray, Optrex Actimist 2 in1 Tired & Uncomfortable Eye Spray, Optrex Sore Eyes*, Refresh Plus (PF) , Refresh Tears Plus, Refresh Liquigel, Systane [GENERAL SALE] eg, lubricant eye ointment (Refresh Night Time Eye Ointment (PF) , Viscotears Gel) These may temporarily blur vision after instillation. Blepharitis is not curable but daily lid hygiene can help control the symptoms. Lubricating eye drops also help to supplement the inadequate natural tear film. Antibiotic drops are only required if the blepharitis is not kept under control with lid hygiene. Lubricant eye drops [GENERAL SALE] eg, Celluvisc Drops (PF) , Clear Eyes Eye Mist Spray (PF) , GenTeal (PF , Optive, Optrex ActiMist 2 in 1 for Dry & irritated Eyes, Refresh Plus (PF) , Refresh Tears Plus, Refresh Liquigel, Systane Antibacterial eye drops [PHARMACY ONLY MEDICINE] eg, propamidine isethionate (Brolene Eye Drops) Consider using single-use wipes to keep eyes clean. Topical antibacterial/antibiotic drops may prevent secondary infection occurring when the stye ruptures, but are usually not necessary. Hypoallergenic pH-balanced wipes eg, Clear Eyes Wipes, Fess Little Eyes Wipes Locate this icon throughout the Healthcare Handbook. Then find the corresponding Pharmacy Today and ELearning articles. Read all three to unleash learning prizes and giveaways! Page 67

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