Treatment options
Treatment options
The treatment choice will depend on the individual’s symptoms and the cause. Use the WWHAM questions and refer to the pharmacist when necessary. Always ask if the customer wears contact lenses – this may influence product choice and any advice given – and check product labels to determine suitability. Customers who wear contact lenses and have red eyes may have an infection, so always check with the pharmacist.
Treatment suggestions
Bacterial infective conjunctivitis may be treated using OTC antibacterial eye drops or ointments. Active ingredients include chloramphenicol and propamidine isethionate, and brands include Brochlor, Brolene and Optrex Infected Eye Drops. If no improvement occurs within the specified treatment time (see individual product labels), the customer should be referred to the pharmacist.
Allergic conjunctivitis
Sodium cromoglicate is a mast cell stabiliser that helps reduce the amount of histamine released when a susceptible individual encounters an allergen such as pollen. OTC brands include Opticrom Allergy, Optrex Allergy and Murine Hayfever Relief. Some products are not suitable for children under six years of age.
Irritant conjunctivitis
Eye drops containing naphazoline relieve redness by reducing the size of blood vessels in the conjunctiva. These may be useful for redness caused by temporary irritation. Brands include Optrex Bloodshot Eyes.
Eye drops, sometimes called ‘artificial tears’, are designed to relieve the discomfort and irritation of dry eye syndrome. Soothing ingredients include sodium hyaluronate, carbomer, hypromellose and witch hazel. Look for suitable products from OTC brands Biotrue, Hycosan, Optrex, Murine and Systane.
Eye sprays (e.g. Optrex Actimist) relieve symptoms of dry, irritated, itchy eyes and can be sprayed onto closed eyes three to four times a day.
Reusable heat masks are also available (e.g. Optase Moist Heat Mask), which can help to soothe dry eye, blepharitis and styes.
When choosing between drops and ointments, some customers may find drops easier to administer or may dislike the additional blurring of vision experienced with ointments. Others may prefer the longer-lasting effects of ointments, particularly if they use the product at night.
Remind customers about good hygiene: wash hands before and after applying medication and don’t touch the applicator tip to the eye’s surface. They should also note any expiry dates, storage requirements – some products need refrigeration – and not to use open products for longer than stated on the label.
When to refer
In addition to your pharmacy protocol, you should refer a customer to the pharmacist if they have:
- Persistent dry eye symptoms not helped by OTC products
- Prolonged, unexplained tearing
- Conjunctivitis that persists for longer than two weeks
- Eye pain, especially if it’s accompanied by redness
- Sensitivity to light or are seeing halos around lights
- Sudden changes in vision
- Any eye injury
- A foreign body in the eye that can’t be removed.
You should also refer infants and any customer who has diabetes.
