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Ophthalmic Disorders

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by

Nadda El-Faham

on 23 May 2014

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Transcript of Ophthalmic Disorders

Ophthalmic Disorders
Dry Eye
Allergic Conjectivitis
Symptoms
Patient Counselling Tips
How to Avoid Contamination!
Blow Trauma
Glaucoma and Cataract
- Avoid
Rubbing
the Eyes
- Avoid
Swapping
of eye drops
-
Throw out
the bottle after the recommended time usually
4 weeks

- Using
contact lenses

- Space
multiple medications

- What to do when
Missing a dose
!
A condition associated with
increased intraocular Pressure

A Patient asks for
Prisoline
eye drops and
Marcophen
a combination he tried to relief some symptoms.
I notice some
fat white spots
on his
iris
.
A swelling in the
uvea
which delivers most of the
blood supply
to the retina
Cortecosteroids
Ophthalmic corticosteroids are
Prescription Only
drungs.
Prescripton Contraindication
Eye Anatomy
Eye Anterior
Parts
Patient Complains from feeling something in his eyes with pus discharge.
Possible infective disorders.
Corneal Ulcer
An open sore in the cornea
Causes :
1.Bacterial infection
2.Viruses and Fungi
3.Chemical burns
4.Others
Symptoms :
-Redness
-Pain
-Ichy sensation
-Pus discharge
Treatment
- Anti-infective agents
- Removal of contact lenses
- Immuno-suppressive agents
As a pharmacist I can only interfere in
mild
cases by giving advice and OTC medication.
Bacterial Conjunctivitis
Types
Acute
Hyper Acute
Chronic
- Red eye
- Iching
- Pus discharge
Almost all cases of
Acute
bacterial conjunctivitis are
self-limited
and will clear up within
10 days
without treatment.
First Line Treatment
Anti-bacterial agents
Polymycin + Oxytetracycline
Chloramphenicol
Isomephenicol
drops
Lomefloxacin
Allergic Reactions
Eye allergies are usually associated with other allergies particularly
hay fever
( allergic rhinitis ) and
atopic eczema
( dermatitis )
When you open your eyes, the
conjuntiva
becomes
directly exposed
to the environment without the help of filtering system
The Reason why the eye is an easy target for allegies .
Symptoms
- Redness
- Ichiness
- Swollen eyelids
- Runny eyes with pus discharge
- Other allergic symptoms such as a Runny nose
Treatment
Topical antihistamines and decongestants as
Topical anti-inflammatorys
NSAIDs
Home Management of
Mild
Allergies
1. Apply Cold cpmresses
2. Flush the eye with lukewarm water
3. Keep Eye drops Refrigerated
How to differentiate between them ?
Corneal Ulcer
Bacterial conjunctivitis
Allergic reactions
- There is an open sore that looks like a
grey or white spot
on the cornea
-
Swelling
in the cornea around the ulcer
- Could be either in
one eye or both
-
Burning
sensation
-
Light sensitivity
-
Red eye
as other conjunctivitis
- Nearly same as other disorders associated with
ichiness
- Differs in the sense that
there are other allergic symptoms
like Runny nose and Sneezing
Gradually cause a
painless loss of transparency
The most Common Types of Glaucoma
Primary open-angle glaucoma
Angle closure glaucoma
Signs/Symptoms
- Halos around lights
- Blurred vision
- Eye and Head pain
Most Commonly prescribed Eye Drops
Signs/Symptoms
- Clouded, Blurred vision
- Fading or yellowish colors
Treatment
Surgery
Ophthalmic Disorders
Latanoprost
Timolol
Brimonidine
Pilocarpine
Catalin
Brinzolamide
Asthma
Hypertension
Eye Trauma
Eye Burn
Foreign Body in the Eye
Eye Injuries
Symptoms :
- Swelling and Bruising
- Eyelid cut
- Blurred vision
- Black eye
- Hyphema
Managment
Minor

- Apply
Cool
Compressors
Major

-
Refer
to Doctor
Foreign Bodies in the Eye
Symptoms
- Feeling pressure
- Pain
- Extreme tearing
- Redness

Presence of:
- Sawdust
- Dirt
- Sand
- Cosmetics
- Contact lenses
Presence of:
- Metal Piece
- Glass shards
Managment:
- Restrict Eye Movement
- Bandage
- Paper cup
- Cover uninjured
Managment :
Take
immediately
to an Emergency Room
Stye
Red bump due to inflammation of eyelid oil glands and Bacterial infection
Symptoms :
- Photosensitivity
- Tearing
- Tenderness
Managment :
- Warm compressors
- Do Not Squeeze
- Avoid Makeup on the area
Refer to a physician when size
increases

Antibiotics
Drainage of the stye
Regimen
- Polymxin B sulphur
- Bocitracin Zn
- Neomycin
-
Hydrocortison
Belpheritis
Inflammation of Eyelids due to
Staph
infections.
Will be explained furthur through the
poster
Eye Burns
Chemicaly
Thermaly
Acid
- Proton
- Anion
Base
Chemical Burns
Alter Eye pH
Coagulates eye proteins
Mostly
Doesn't
Penetrate deeper into the tissues
- Hydroxyl group
- Cation
Saponification
Management
- Person's face position
- Continous clean water irrigation
- MorTan
Symptoms
- Severe Pain
- Difficulty to open eye
- Irritation
Pressure
N.B.
-
Why
use Water ?
( Restore eye pH which is
6-8
)
- American journal emergency medicine.
(
BSS
is the most suitable )
- Water as a
Hypotonic
??
Flash Burns
- U.v/Black/Sun light
- Hallogen lamp
- Methoxsalen

Thermal Burning
Sources
Eye Burns
Symptoms :
- Painful inflammation
- Blurred vision
- Light sensitivity
Sources :
Uvietis
Parts of Uvea
Anterior
Posterior
- The Iris
- The Pupil
- Ciliary body
- Choroid
Inflammation of Iris, Ciliary body and Choroid is called
Pan-uvietis

Causes :
- Auto-immune disorders
- Inflammatory disorders
- Infections
Symptoms :
- Red blood shot eyes
- Pain
- Photo-phobia
- Blurred vision with Floaters
- White area
Treatment
If uvietis develops because of an underlyning problem, treatment/management will need to
focus on that precise causal problem
.

Medication is given to
relief symptoms
as a corticosteroid antibiotic combination
Prevention
- Use eye
protection

- Keep up to date to
vaccination
- Practicing good
Hygiene
- Regular
health checkups
with a primary care physician
Uvietis Cannot always be prevented particularly since some cases are
idiopathic
N.B.
Complications
- Glaucoma
- Optic Nerve Damage
- Cataract
- Loss of Vision
- Prolonged exposure to light
( Bakery )
Maybe in cases of :
- Older than 50
- Postmenopausal woman
- Have a Certain Medical Condition
- Laser Eye Surgery
- Tear glad damage
Caused by a lack of adequate tears
Additional Causes:
- Wind
- Dry Air
- Tasks Requiring lots of concentration
Medications
that may cause dry eye
Symptoms
- Eye fatigue
- Light Sensitivity
- Difficulty wearing lenses
- Excessive tearing
- Eye redness
- Blurred vision
Treatment
Inflammation n the
conjunctiva
due to allergies. Most common cause is
hay fever
.
Symptoms :
- Intense itching or burning
- Puffy eyelids
- Red eyes
- Stringy eye discharge
- Tearing
Treatment
The
best
treatment is to
Avoid
what causes your allergy symptoms
Eye burning
Eye penetration
Cut
Blow trauma
Foreign Bodies
Less
Dangerous

Eye Penetration
Cut
NO
PRESSURE
May Apply
Gentle
Pressure
??
VS.
Refrences :
- www.drugs.com
- www.medscape.com
- www.medicinenet.com
- www.glaucoma.org
- www.nhs.uk
Mayar Mekkawy
Mayar Naguib
Nermin Samuel
Mirna Joseph
Nada El-Faham
Contraindications
- Glaucoma
- Most Viral diseases
- Fungal diseases
- Mycobacterial infections
Why ?!
Due to the fact that
- they decrease host resistance to infectious agents
encourging secondary infection
- May
mask
infection symptoms
Examples
Dexamethazone
Prednisolone
Florometholone
Some Patient Counselling Tips
- Temporary
sting
- Temporary
blurred
vision
- Store at room temprature
- Always
shake
the bottle very well before using
- if used for
10 days
or longer advice to be monitored routinely
In
less
serious ocular infections ophthalmic coticosteroids could be used. But, with
caution
and accompanied by appropriate antimicrobial agent.
N.B.
Dexamethazone + Neomycin
Dexamethazone + Polymyxin B + Neomycin sulphate
Dexamethazone + Tobramycin
Some Cases of Referral
- Synchiae
- Disconnected Cornea
- Blind spots in Peripheral Vision
- Intense Eye Redness
Refrigeration
Maintain the stated
potency
and ensure
safety
until it's expiry date.
Eye Cup
Interact with stromal collagen
Goes Deeper
into the tissues
Some More Cases of Referral
- Sudden onset Double Vision
- Bulging Eye
- Floaters and flashing lights
- Sudden Vision loss
Full transcript