I've got an eye for you

The human eye may only be 2.5 cm in diameter, but it is an amazing and powerful piece of anatomical engineering. It links us to the world around, allowing us to communicate with people, absorb our surroundings and to appreciate the space in which we live. However, as the eye is nearly constantly exposed to the elements around us, it means that it can be subject to a number of health complaints. When this happens, our quality of life decreases dramatically and often an appointment with the GP or a visit to the pharmacist is needed to sort the problem out.

To save a visit to the doctor, this article looks at some of the most common eye complaints and gives advice on how to treat these conditions with self-help tips, or over-the-counter remedies and advice from the pharmacist.

Blepharitis
Blepharitis is inflammation of the eyelids. It usually affects the edges of the eyelids. It is not usually serious, but can be an irritating, uncomfortable, problem. Blepharitis is typically chronic, which means that once you have it, chances are you will have it again at some point in your life.

Typical symptoms of blepharitis are itchy, uncomfortable eyelids. The eyelids may look inflamed and sometimes greasy and occasionally tiny flakes or scales resembling fine dandruff may appear on the eyelids.

Dandruff of the scalp and eyebrows at the same time is also common and sometimes crusts may develop at the base of the eyelashes, which may make it difficult to open your eyes in the morning. Sometimes the eyelids also become infected, in which case the eyelids may then become sore and more inflamed.

Regular eyelid hygiene is the most important part of treatment and prevention.

• Bathe the eyelids and apply gentle pressure with a flannel (facecloth) soaked in warm water for 5-10 minutes. This softens the skin and any crusts attached to the eyelids. Keep re-warming the flannel in hot water if it cools.
• Massage the eyelids - gently press on any tiny glands that may have formed on the lids to push out any of the mucus-like fluid.
• Clean the eyelids with a cotton wool bud. First dip the cotton bud in a mixture of baby shampoo and water (half and half). Squeeze out excess liquid from the cotton bud to prevent drips getting into your eyes as this may irritate. In particular, try to clean off any crusts at the base of the eyelids.
• Wash off the shampoo from the eyelids with a flannel or cloth.
  The above routine should be repeated at least twice a day until symptoms settle. When the symptoms have gone, keep performing this routine once a day, every day, to prevent further flare-ups.

Your pharmacist can recommend OTC eye drops for the treatment for blepharitis. If these do not resolve the condition, visit your GP who may prescribe an antibiotic eye treatment.

Antibiotic eye ointment may be advised for a while if an eyelid becomes infected. Place the ointment on the edge of the eyelid (not the eye) after cleaning the eyelid in the way described above. A course of eye ointment will usually last approximately one month or until the inflammation has gone. In a very small number of cases, antibiotic tablets may be needed if antibiotic ointment does not clear an infection.

Some people with blepharitis also produce less tears than normal. This may lead to 'dry eyes', which can feel gritty and sore. Artificial tear eye drops will help if you develop dry eyes.

Infective Conjunctivitis
Conjunctivitis is inflammation of the conjunctiva, the thin 'skin' that covers the white part of the eyes and the inside of the eyelids. Many different viruses and bacteria can cause conjunctivitis, but most bouts of infective conjunctivitis are not serious, and soon clear. Conjunctivitis can also be caused by an allergic reaction.

Sometimes only one eye may be infected, but it usually spreads to both eyes. The eyes may feel gritty and water more than usual, and may be a little sore. Thankfully, vision is not normally affected, although your eyes may look inflamed, and red or pink in colour. The eyelids may become swollen, and are often stuck together with gluey material after a sleep.

Treatment
Mild infections do not always require treatment, as our tears contain chemicals that fight off bacteria and allow the infection to clear up by itself. However, if symptoms get worse or do not improve, your pharmacist can recommend OTC eye drops for the treatment for conjunctivitis. If these do not resolve the condition, visit your GP as treatment may be needed in the form of antibiotic eye drops or ointment. Although antibiotics do not kill viruses, an antibiotic will clear any bacteria, and prevent secondary bacterial infection of a viral conjunctivitis. Conjunctivitis caused by chlamydia or the herpes virus is more serious and may need special treatment.

Don't forget:

• Tell your doctor if you are pregnant as some antibiotic eye drops are not suitable
• Do not to wear contact lenses when you have conjunctivitis or when you use antibiotic eye drops or ointments.

Some types on conjunctivitis can be more serious than others therefore visit your doctor if any of the following occur:

• Symptoms do not settle within a few days.
• Symptoms change (for example, light starts to hurt your eyes).
• Pain becomes worse (mild soreness rather than pain is usual with conjunctivitis).
• Spots or blisters develop on the skin next to the eye.
• Your vision becomes affected.
  

Stye
A stye is an infection in the root of an eyelash: when infected, the root swells and fills with pus and develops into a small red lump on the edge of an eyelid. The infection may spread along the eyelid and the whole lid may become red and inflamed. There may be also be a small spot of yellow pus where the affected eyelash comes out of the eyelid. The usual bacterium (germ) that causes the infection is called staphylococcus. This is a common bacterium that is often found on healthy skin. It usually does no harm, but sometimes it can invade the skin to cause infections such as boils, abscesses and styes.

What is the treatment for a stye?
Often, no treatment is necessary as most styes burst and the tiny amount of pus drains away leaving no further problem. However, there are things you can do to help ease soreness and clear the pus:

• A hot compress may prove handy. Hold a clean flannel that has been in hot (but not scalding) water gently but firmly against the closed eye. Do this for about 20 minutes, 3-4 times a day
• If the stye does not clear, an antibiotic ointment may be prescribed. Severe infections may require an antibiotic medicine.
  

How to Use Eye Drops

1. Wash your hands.
2. Sit down in front of a mirror so that you can see what you are doing
3. Tilt your head back and look upwards. Gently pull your lower eyelid down
4. Hold the dropper above your eye - avoiding touching the tip against your eye or eyelashes - and squeeze one drop inside your lower eyelid
5. Release the lower eyelid and blink a few times to make sure the whole of the eye is covered by the liquid
6. Wipe away any excess with a clean tissue.
7. If you need to put in more than one drop, wait a few minutes before putting the next drop in. If you do not wait then the first drop may be washed out by the second before it has had time to work.

Your eye-drops have been tested to make sure that they are free from germs when you receive them. In order to keep them in good condition, follow these simple rules:

• When not in use, keep the bottle tightly closed in a cool, dark place
• If the dropper is separate, DO NOT put it down on any surface
• DO NOT allow the dropper or dropper nozzle to touch your eye or your fingers
• NEVER lend your eye-drops to anyone else
• Eye drops should not be used for longer than four weeks. This is because they can become dirty and infected. Write the date that you open the bottle on the label so that you will know when to throw them away
• DO NOT wear contact lenses until your course of eye-drops is finished, unless you have been told otherwise
• If you have any questions about your eye-drops or any other medicines, your pharmacist can help.

How to Use Eye Ointment
Follow points 1 - 4 above then:

1. Squeeze about 1cm of ointment along the INSIDE of the lower eyelid. Close your eye and blink several times to allow the ointment to spread over the surface of your eye
2. Wipe away any excess ointment from the eyelid or eyelashes using a clean tissue
3. When you open your eye, your vision may be blurred. This will be cleared by blinking. Do not rub your eyes!

Your eye ointment has been tested to make sure that they are free from germs when you receive it. In order to keep them in good condition, follow these simple rules:

• When not in use, keep your eye ointment in a cool, dark place
• DO NOT allow the tube to touch your eye or your fingers
• NEVER lend your eye ointment to anyone else
• Eye ointments should not be used for longer than four weeks. This is because they can become dirty and infected. Write the date you opened the tube on the label so that you will know when to throw it away
• If you are using eye-drops as well as eye-ointments, you should use the drops first. Leave a gap of at least five minutes between using the drops and using the ointment
• DO NOT wear contact lenses until your course of eye ointment is finished unless you have been told otherwise
• If you have any questions about your ear-drops or any other medicines, your pharmacist can help