Home' Australian Pharmacist : Australian Pharmacist February 2011 Contents Vol.30–February#02
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
they may have. Generally, purulent
discharge is associated with bacterial
infections and watery discharge with
viral. Patients with discharge should be
seen by an optometrist to assess the
severity of the infection. In most cases
topical treatment can hasten recovery.
Itching, burning, stinging?
Typically a symptom of itch suggests
an allergic-type condition. Burning and
or stinging require optometric referral
In all cases, when a patient presents
with an eye-related problem,
initial questioning and advice will
influence the patient’s management,
compliance and overall outcome.
If you believe that topical treatment
could benefit the patient, they should
be encouraged to present to their
local optometrist for investigation.
The optometrist will then examine
the patient under high magnification,
make a diagnosis, instigate treatment
immediately or refer them on to
an eye specialist if required. This
process will ensure the patient
receives the best ocular care and
management possible, in a timely
and cost-effective manner.
The increased scope of optometry
practice to include prescribing
ocular medications has obvious
significant benefits to the community.
The promotion and continuing
• Call optometrist if any concerns.
• Reassure the patient.
Pharmacists will often be the first
health professional a person presents
to with an eye problem. There are
several eye conditions that a person
may be suffering from, which at first
glance may all appear very similar.
Asking the patient a selection of
key questions will help determine a
possible cause and assist in providing
the most appropriate professional
advice. Figure 1 is an easy guide to
assessing ‘red eyes’ and determining
which patients need to be referred
to an optometrist promptly for
investigation. Questions to ask include
Pain, blurred vision,
A patient with any pain in or
around the eyes, blurred vision or
photophobia should be referred to
an optometrist as soon as possible.
Possible causes may include sight-
threatening conditions such as acute
uveitis (or iritis), acute glaucoma
The type of discharge a patient
is experiencing will offer some
information on the type of infection
development of a strong professional
relationship between optometrists and
pharmacists will absolutely improve
patient outcomes for those presenting
with ocular issues. It will further
ensure that all of these patients
will receive effective ocular care in
an appropriate and timely manner.
The future is clear: professional
collaboration is the key to optimising
the vision of all Australians.
Key learning points
• The scope of optometry practice
includes treatment of eye
conditions and prescription of ocular
• Therapeutically endorsed
optometrists in all states
are permitted to prescribe a
comprehensive list of restricted
• Pharmacists should have an
understanding of the legal
requirements when dispensing an
• Pharmacists should have an
understanding of possible diagnoses
and feel confident in referring onto a
local optometrist for investigation.
1. Optometry Board of Australia. At: www.
2. Optometrists Association of Australia. At: www.
3. The Schedule of Pharmaceutical Benefits [online]. At:
4. Kanski J. Clinical Ophthalmology. 6th ed. USA:
1. A patient presents with an
uncomfortable, red, watery right
eye. After taking a history, you
consider viral conjunctivitis as
a possible cause and decide the
local optometrist should assess
the patient to check. You advise
the patient the following:
a) You first need to see your GP for
a referral to see an optometrist
about your eye.
b) Your local optometrist can see
you without a referral and will
usually bulk bill. It would be a good
idea to phone today to make an
c) Your optometrist will charge you a
fee to have your eyes tested.
d) Your eye is red and watery. Please
go straight to the hospital.
2. Some eye conditions that
optometrists can safely
a) Bacterial conjunctivitis, fungal
keratitis and uveitis.
b) Bacterial conjunctivitis, dry eye and
c) Bacterial conjunctivitis, herpes
simplex keratitis and herpes zoster
d) Bacterial conjunctivitis, dry eye and
herpes zoster ophthalmicus.
3. When dispensing an optometry
prescription, a pharmacist’s
a) Check optometrist against list of
b) Check medication against list of
approved optometric medications.
A score of 3 out of 4 attracts 0.75 CPD credits.
c) Call optometrist if any concerns.
d) All of the above
4. A patient presents covering
their left eye with their hand
and is in horrific pain. Their
eye is very red, watery and
their vision is blurred. Possible
causes and consequent
recommendations may include:
a) Uveitis or acute glaucoma – see
your optometrist as soon as
b) Viral conjunctivitis or dry eye –
recommend ocular lubricant.
c) Allergic conjunctivitis –
recommend antihistamine drops.
d) Bacterial conjunctivitis –
supporting pharmacy practice
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1 Niedzielin K, Kordecki H, Birkenfeld B. A controlled, double-blind, randomized study on the efficacy of Lactobacillus plantarum 299V in patients with irritable bowel syndrome. Eur J
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