Home' Australian Pharmacist : Australian Pharmacist April 2016 Contents Australian Pharmacist April 2016 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
7. Chang-Miller A. Can rheumatoid arthritis affect the
eyes? In: Mayo clinic. 2013. At: www.mayoclinic.org/
8. Fraunfelder FT, Sciubba JJ, Mathers WD. The role
of medications in causing dry eye. J Ophthalmol
9. Psychotropic Expert Group. Therapeutic guidelines:
psychotropic, version 7. Melbourne: Therapeutic Guidelines
10. Sharma RA, Mather R. Five things to know about...dry eye
disease. CMAJ 2014;186(14):1090.
11. Rossi S, ed. Australian medicines handbook. Adelaide:
Australian Medicines Handbook; 2015. At: www.amh.net.
12. Steiner M. On the correct use of eye drops. Aust Prescr
13. Sansom LN, ed. Australian pharmaceutical formulary and
handbook. 23rd edn. Canberra: Pharmaceutical Society of
14. American Academy of Ophthalmology. Dry eye syndrome
– preferred practice pattern (PPP) guideline. 2013. At: www.
15. Pharmaceutical Society of Australia. Red and dry eyes Self
Care fact card. Canberra: PSA; 2013.
1. Which ONE of the following has been
implicated as a cause of dry eye
a) Frequent blinking.
b) Reduced oestrogen.
c) Reduced inter-blink period.
d) Autoimmune diseases (e.g. rheumatoid
2. When instilling eye drops:
a) Patients should instil one drop at a time.
b) The head should not be tilted back.
c) The finger should be placed on top of
the eyelid after application (to reduce
d) The same hand should not be used to
hold open the eyelid and instil the drop.
3. Dry eye syndrome:
a) Is more common in the ageing
population (>80 years).
b) Is more prevalent in males.
c) Cannot be treated with artificial tear
d) Is best treated with tear supplements
4. With regards to artificial tear
supplements, which ONE of the
following is INCORRECT?
a) Single dose unit formulations are
b) A common preservative that is used
in these products is benzalkonium
c) Patients should use the drops four to six
times per day.
d) It usually takes around 6 months to see
an improvement of symptoms when
using these products.
5. In which ONE of the following cases
would you refer a patient with dry
eyes to their doctor?
a) Suspected autoimmune disease.
b) Dry eyes caused by computer screen
c) If the patient is allergic to eye drop
d) Patients >60 years of age.
Six weeks later, Sarina returns to
the pharmacy to inform you of her
progress. She visited her doctor
after your recommendation, and she
was prescribed some artificial tear
supplements, which she has been using
three to four times a day. At the same
time, her doctor was concerned that the
Endep (amitriptyline) may have been
causing her symptoms so he decided to
switch Sarina to another antidepressant,
to see if this made any difference. Sarina
followed a strict withdrawal protocol,
and gradually started taking sertraline
50 mg, once daily. She has only been
taking the sertraline for three weeks
now, and she notes that her eyes are not
as dry and sore, and she no longer needs
to use her tear drops. Sarina mentions
that she has felt extremely stressed
(with a low mood) during this period,
and her doctor assured her that her new
antidepressant medicine should start to
work within a month. She notes that she
is feeling better each day. Sarina thanks
you for your help, and is very happy that
she no longer has these troublesome
KEY LEARNING POINTS
There are various potential causes of
dry eye syndrome. It is essential that
pharmacists elicit a detailed patient
history, in determining the potential
causes of dry eye syndrome. In cases
where a medicinal cause is suspected,
patients should be referred to their
doctor for review and treatment
recommendations. The most common
treatment for dry eye syndrome is
artificial tear supplementation. Ideally,
a tear drop with no preservatives is less
likely to cause further irritation. It is also
important that the pharmacist counsels
the patient on the correct technique
required when instilling eye drops, to
ensure they work effectively.
1. Sharma A, Hindman HB. Aging: a predisposition to dry eyes.
J Ophthalmol 2014;2014:781683.
2. Albietz J. Dry eye: an update on clinical diagnosis,
management and promising new treatments. Clin Exp
3. National Eye Institute (NEI). Facts about dry eye. 2013. At:
4. Truong S, Cole N, Stapleton F, et al. Sex hormones and the
dry eye. Clin Exp Optom 2014;97(4):324–36 .
5. Hajj-ali RA. Sjögren Syndrome (SS). In: MSD manual
(professional version). 2013. At:
Links Archive Australian Pharmacist March 2016 Australian Pharmacist May 2016 Navigation Previous Page Next Page