Eyes on the prize

Conjunctivitis is due to inflammation of the thin transparent film that covers the white part of the eye and under the upper eyelid. It’s usually caused by an infection or allergy. Viral or bacterial conjunctivitis should get better in a couple of weeks without any treatment. However, some sexually transmitted infections, such as gonorrhoea and chlamydia, can cause conjunctivitis symptoms for longer than this. Allergic conjunctivitis usually lasts for a few months or may even be present all year round.

“Bacterial conjunctivitis is typically accompanied by a yellow/green discharge,” explains Max. “This helps differentiate it from allergic conjunctivitis with a clearer discharge. Treatment should be appropriate for the condition, although bacterial conjunctivitis is usually a self-limiting condition.”

Viral or bacterial conjunctivitis is highly contagious so it’s important to follow good hygiene while the symptoms last – taking care not to pass it onto someone else. To ease the symptoms, customers should be advised to boil some water and leave it to cool down. Then soak some cotton balls in the water and gently wipe any crusts from the eyes. They can do this in the morning and up to two more times during the day. Holding a cold flannel to their eyes will cool down any burning or itching. 

Pharmacy customers can also buy eye drops, sprays and pads to soothe allergy symptoms, OTC eye drops for minor eye infections and chloramphenicol-containing eye ointments for bacterial conjunctivitis.

Eye floaters are little flecks in the vision that become more noticeable when looking at a bright and plain background such as a white wall. When moving the eyes, the floaters quickly shift to the side and can’t be seen anymore. Eye floaters never completely go away, but they often get less visible over time as the brain gets used to them.

“Floaters can be the early sign of a more serious eye condition such as retinal detachment or a less-worrying part of the eyes’ ageing process, such as a posterior vitreous detachment,” says Max. “Without specialist equipment to examine the posterior eye, pharmacists should refer patients to their optician’s practice or if associated with vision loss to seek urgent or emergency eyecare within the hospital eye service or A&E.”

Alastair Lockwood, ophthalmologist and eye health advisor for Feel Good Contacts, says that eye floaters are usually nothing to worry about, but a sudden increase needs to be checked out, as well as a dark shadow or curtain in one side of peripheral vision. “Age-related eye floaters can’t be prevented,” he says. “However, you can avoid eye floaters caused by injury by wearing eyewear to protect your eyes when carrying out tasks that require the use of dangerous tools or when playing certain sports. You can reduce the likelihood of getting floaters as a result of a vitreous haemorrhage caused by diabetic retinopathy, by improving your blood sugar levels.”

Most people get one or two styes in their lifetime. A stye is a small pus-containing abscess on the outside of the eyelid, usually caused by a bacterial infection. It looks like a small red lump with a yellow spot in the middle and may cause a red and watery eye or eyelid.

“Styes can be quite painful,” says Max. “They appear often overnight, and it is the discomfort that distinguishes them from a chalazion (a minor infection of the Meibomian glands). Management is to try and remove the eyelash if that’s still in place and hot compresses.”

The customer should apply consistent heat to the stye for a minimum of seven to 10 minutes at a time. “This is often difficult to achieve with a face cloth and wash basin of water, so a microwavable eye bag is often recommended,” adds Max. “If home treatment is ineffective, then routine referral to GP is recommended for antibiotic treatment or onward referral.”

Blepharitis is caused by inflammation of the rims of the eyelids. It’s often a reaction to bacteria that live naturally on the eyelid skin, which then affects oil production. Symptoms include burning, soreness or stinging in the eyes, crusty eyelashes and itchy eyelids. The condition is more common in people with seborrheic dermatitis, rosacea or acne, or may be caused by preservatives in glaucoma eye drops.

Blepharitis can often be treated with warm compresses to improve the flow of oil in the eyelids. Using an eyelid cleansing product (e.g., gel, foam, wipes) may help with lid hygiene to remove debris, dirt, oil and pollen. There are also eyelid products to improve oil production and/or kill a broad spectrum of bacteria, viruses and fungi. 

“Blepharitis is one of the most common underlying reasons that cause patients to seek dry eye advice,” says Max. “Therefore, patients presenting with sore red lid margins should be offered appropriate over-the-counter blepharitis treatment along with suitable evaporative dry eye products.”