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MODULE 4: AUGUST 2015 Professional_Assistant _ Aug_eye careV1_Q8.LN_G_Layout 1 13/08/2015 14:23 Page 2

DID YOU KNOW? Contact lenses can’t get lost behind the eye because the conjunctiva, which ? covers the white of the eye, also lines the .

Understanding the problem

The eye conditions you’ll tend to encounter in the pharmacy are most likely to be minor, such as dry eye, and styes. Conjunctivitis This condition tends to occur when insufficient tears are produced or when This term applies to any condition causing redness and the tears that are made don’t have the inflammation of the conjunctiva. correct consistency and so evaporate There are three common types: too quickly. It is more common in older people and in women. Infective conjunctivitis 1 Caused by a bacterial or viral Symptoms include: infection; can be contagious. • Redness The whites of the eyes will • Stinging or a burning sensation look pink and the eyelids may • Gritty, irritated feeling be red and swollen (see • Temporary picture, right). Sufferers may • Decreased tolerance for reading or also complain of a sticky, working on a computer. yellow coating or discharge on the upon Possible causes include: waking. One or both eyes • Hormonal changes (e.g. menopause, may be affected. pregnancy) • Certain medicines (e.g. antihistamines, oral contraceptives) 2 Symptoms occur because of an allergic reaction to pollen, • Wearing contact lenses dust mites, animal dander, etc. Both eyes are usually affected. • Recent laser eye surgery Sufferers will complain of watery, itchy eyes and there may be • Environmental factors (e.g. low humidity, a stringy discharge. wind, high altitude, exposure to smoke, high pollen levels) Irritant conjunctivitis • Prolonged reading, using a computer, etc 3 Caused by contact with • Other health conditions (e.g. rheumatoid substances that irritate the arthritis, diabetes, allergies, ). conjunctiva (e.g. shampoo, chlorinated water, smoke). There is no cure for dry eye syndrome, and Eyes will look red and feel some people may suffer from recurring tired, sore or irritated (see episodes throughout their lives. However, picture, right). Symptoms OTC treatments, coupled with relevant tend to resolve once the lifestyle changes, can relieve symptoms. irritant is removed.

Styes and blepharitis Usually caused by a bacterial infection, styes appear be a complication of another condition such as seborrhoeic like a pimple on the outside or inside of the . dermatitis or . Symptoms include itchy, sore eyelids, crusty eyelashes and eyelids that stick together upon waking. Styes are fairly common and most resolve without treatment within a few days or weeks. A warm compress may be used Blepharitis is not usually serious, but it can be a long-term, to encourage the stye to release and heal more quickly. chronic condition. There is no cure, but establishing a daily eye-cleaning routine may help to control symptoms. In blepharitis, the rims of the eyelids become inflamed, red and swollen (see picture, right).

Blepharitis can develop at any time, but is more likely in people over 40. It may be caused by a bacterial infection or Professional_Assistant _ Aug_eye careV1_Q8.LN_G_Layout 1 13/08/2015 14:23 Page 3

DID YOU KNOW? Don’t forget... One in five children have an ! ? undetected vision problem. Tears are not simply water – they are a complex, balanced mix of chemicals that help keep eyes healthy. Every time we blink, a thin layer of tears spreads across the eye’s surface. This film forms a protective coating, lubricating the eye and washing away foreign Added advice material. These tips can help your customers take care of their eyes: • Get plenty of sleep • Eat a healthy, balanced diet with a variety of fruit and vegetables. Opt Treatment options for oily fish twice a week for essential omega-3 fats The treatment of choice will depend on the individual’s symptoms and their • Drink plenty of water and not too cause. Use the WWHAM questions and refer to your pharmacist when necessary. much alcohol • Protect the eyes from the sun Always ask if the customer wears contact lenses, • Stay active as this may influence product choice, and check • Quit smoking product labels to determine suitability. When • Have regular eye check-ups choosing between drops and ointments, • Take regular screen breaks when some customers may find drops easier working at a computer to administer or may dislike the • Use a humidifier or a filter if additional blurring of vision seen with air quality is affecting the eyes ointments. Others may prefer the • Wear safety glasses or longer-lasting effects of ointments, goggles during DIY or when particularly if they use the product playing sports, etc at night. • Remove any eye make-up properly before going to bed. Also, remind customers about good hygiene: wash hands before and after applying medication and don’t When to refer touch the applicator tip to the eye’s You should refer a customer surface. They should also note any to the pharmacist if they have: expiry dates and not use open products • Persistent dry eye symptoms not for longer than stated on the label. helped by OTC products • Prolonged, unexplained tearing • Conjunctivitis that persists for Treating dry eye longer than two weeks Eye drops, sometimes called ‘artificial tears’, • Eye , especially if it’s are designed to relieve the discomfort and irritation of dry eye syndrome. accompanied by redness Soothing ingredients include propylene glycol, PEG400, carbomer, hypromellose • Sensitivity to light or seeing halos and witch hazel. Look for suitable products from OTC brands Systane, Optrex, around lights Murine and Biotrue. • Sudden changes in vision • Any eye injury More recently, eye sprays have been introduced (e.g. Optrex Actimist). These • A foreign body in the eye that can’t relieve symptoms of dry, irritated, itchy eyes and can be sprayed onto closed eyes be removed. three to four times a day. You should also refer infants and any customer who has diabetes. Treating infective conjunctivitis Bacterial infective conjunctivitis may be treated using OTC antibacterial eye drops or ointments. Active ingredients include , propamidine isethionate and dibromopropamidine, and brands include Brochlor, Brolene, SIGNPOSTING Golden Eye and Optrex Infected Eyes. If no improvement occurs within the For more information, specified treatment time (see individual product labels), the customer should you can: be referred to the pharmacist. • Use your Counter Intelligence Treating allergic conjunctivitis Plus training guide Sodium cromoglicate is a mast cell stabiliser that helps reduce the amount of • Visit NHS Choices: histamine released when a susceptible individual encounters an allergen such www.nhs.uk as pollen. OTC brands include Opticrom Allergy, Optrex Allergy and Murine Hayfever Relief. Some products are not suitable for children under six. • Visit The Eyecare Trust: www.eyecaretrust.org.uk Treating irritant conjunctivitis • Learn about events happening Eye drops containing naphazoline relieve redness by reducing the size of blood during National Eye Health vessels in the conjunctiva. These may be useful for redness caused by temporary Week, 21-27 September, 2015. irritation. Brands include Murine Irritation and Redness Relief and Optrex Visit: www.visionmatters.org.uk Bloodshot Eyes. Professional_Assistant _ Aug_eye careV1_Q8.LN_G_Layout 1 13/08/2015 14:24 Page 4

TEST YOURSELFONLINE GOOD PRACTICE KNOWLEDGE IS IMPORTANT WHEN ADVISING CUSTOMERS

Questions ? Scenario

1) Which of the following statements is Brian is in his 20s and wants advice about eye drops. FALSE? His eyes are feeling itchy and sore and look red. He is a) Sight is actually a series of events triggered by light looking for some relief of his symptoms, but doesn’t b) The lens in the eye can change shape to know what to try. After asking the WWHAM questions bend light rays and focus them on the you establish that Brian suffers from hayfever and that he retina takes loratadine tablets when necessary. c) The iris is a layer of light sensitive cells found at the back of the eye d) The conjunctiva is a mucous membrane that covers the front of the eye and also What would you recommend? lines the inside of the eyelids For each part of this scenario, think about the decision you would make and, 2) Which of the following are possible importantly, why you would take that course of action. Think about how you causes of dry eye syndrome? would talk to your customer and provide the necessary advice. You can discuss this a) Hormonal changes with your team and your pharmacist. b) Wearing contact lenses c) Being exposed to hot, dry, windy 1 2 atmospheres d) All of the above Discuss ways that Brian can control his hayfever symptoms and suggest eye Suggest an antibacterial ointment 3) A teenager who has recently started drops containing sodium cromoglicate to relieve the redness. training with the local swimming club at to relieve his symptoms their indoor pool complains of conjunctivitis. Which type of conjunctivitis is it most likely to be? What if? a) Infective conjunctivitis Brian tells you he has recently started b) Allergic conjunctivitis wearing contact lenses and is not sure if he c) Irritant conjunctivitis is looking after them correctly. d) None of the above 1 2 4) Which product is most likely to benefit someone whose eye symptoms appear to be You talk to him about the type of linked to seasonal allergies? You continue to focus advice on contact lenses he wears and suggest he a) Artificial tears managing hayfever symptoms. discusses his contact care routine with b) Sodium cromoglicate drops his optician to ensure he is looking after c) Chloramphenicol ointment them properly. d) Eyelid wipes

5) Which of the following lifestyle tips will What if? help customers look after their eyes? Brian mentions he spent time with his a) Getting plenty of sleep young nephew at the weekend and has b) Protecting eyes from the sun’s UV rays since heard that the child has infective c) Quitting smoking conjunctivitis. d) All of the above

6) Which customer can safely self-medicate with an OTC lubricant eye drop preparation? 1 2 3 a) A elderly gentleman with type 2 diabetes b) A toddler who has had unresolved Explain the symptoms. If conjunctivitis for the past week Brian is experiencing them, c) A student who finds his eyes sometimes Recommend using Refer Brian to your recommend antibacterial eye pharmacist. get irritated after spending hours working drops combined with good antibacterial eye drops as on a project on the computer hygiene measures (e.g. wash a preventative measure. d) A middle-aged lady who reports becoming hands and avoid sharing very sensitive to bright lights towels and pillows to prevent spreading the infection).

Go to www.tmmagazine.co.uk to submit your answers to these questions. When you pass, you’ll be able to print out a certificate to showcase your learning. You can also add this to your online, personalised learning log. www.tmmagazine.co.uk

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