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Sore uncomfortable eyes

Sore uncomfortable eyes. Christopher Jenkins September 2013. Causes, symptoms and treatments. The biggest cause?. Doctors. Not GP’s. Yes,ophthalmologists !. Drops. Worst drop. Brimonidine ( Alphagan ). Follicular conjunctivitis. Other culprits. Prostaglandin analogues

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Sore uncomfortable eyes

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  1. Sore uncomfortable eyes Christopher Jenkins September 2013

  2. Causes, symptoms and treatments

  3. The biggest cause?

  4. Doctors • Not GP’s • Yes,ophthalmologists!

  5. Drops

  6. Worst drop Brimonidine (Alphagan)

  7. Follicular conjunctivitis

  8. Other culprits Prostaglandin analogues Bimatoprost > Travaprost > Latanaprost Carbonic anhydrase inhibitors Dorzolamide > Brinzolamide Betablockers – anaesthetic effect Laevobunolol > Timolol > Betaxolol Preservatives – benzalkonium chloride

  9. Prostaglandin cosmetics

  10. Single use glaucoma drops

  11. Sore uncomfortable eyes Drops Blepharitis Dry eye Allergic conjunctivitis Foreign body Lid malposition

  12. Blepharitis Discharge in lid margin on awakening Crusting around eyelashes Lid margin red Often unilateral Sore, burning eye, foreign body sensation

  13. Blepharitis

  14. Demodex http://www.youtube.com/watch?feature=player_detailpage&v=16bSxfCS0wI

  15. Dry eye • Scratchy, gritty eyes • Worse • At end of day • When driving • When using computer • Usually bilateral but asymmetrical

  16. Allergy Itchy eyes Often seasonal (hayfever) May occur in winter or year round More common in association with other atopic conditions such as eczema and asthma Unusual to find specific cause

  17. Allergic conjunctivitis

  18. Recurrent corneal erosion syndrome Pain on awakening Associated with trauma or epithelial basement dystrophy

  19. Foreign body

  20. Foreign body Sub-tarsal Suture Contact lens

  21. Contact lenses

  22. Less common Other conditions

  23. Entropion

  24. Treatment of dry eye • Tear replacement • Drops (sodium hyaluronic acid) vs gels (carbomer) • Preserved vs non-preserved • Punctal occlusion • Plugs • Cautery

  25. Treatment of blepharitis andmeibomian gland disease • Lid hygiene • Heat • Massage • Lubrication

  26. Lid hygiene

  27. Heat pads

  28. Cleaning agents

  29. Medical treatments • Lid margin antibiotics • Fucithalmic • Oral antibiotics • Doxycyline • Azithromycin • Anti-inflammatories • Hormonal?

  30. The End

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