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KEY CONCEPTS

KEY CONCEPTS

  • image Pharmacists are often the first healthcare provider that patients will seek with various eye complaints.

  • image It is crucial to understand the various products available over-the-counter (OTC) to provide appropriate recommendations.

  • imageHealthcare professionals should also be familiar with eye conditions that do require referral to a medical provider for further evaluation.

PATIENT CARE PROCESS

Patient Care Process for Eye Complaints

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Collect

  • Patient characteristics (eg, age, sex, pregnancy status)

  • Patient medical history (personal and family)

  • Social history (eg, tobacco/ethanol use)

  • Current medications including prescription, OTC aspirin/NSAID use, herbal products, dietary supplements

  • Objective data

    • Appearance of ophthalmic redness, inflammation, or any other signs

Assess

  • Appropriateness for self-care (eg, red flags that would indicate referral or higher level of care such as bleeding or failed previous attempts at treatment)

  • Presence of anything physically blocking the eye or eyelid

  • Presence of common provoking factors (eg, recent drug use, new medications, changes in weather, history of allergies)

  • Ability/willingness to administer eye drops correctly (eg, health literacy, age of patient)

  • Ability/willingness to pay for OTC options that are not covered by insurance

  • Ability/willingness to follow-up with provider if symptoms do not improve

Plan*

  • Drug therapy regimen including specific eye drops and/or medication(s), dose, route, frequency, and duration

  • Monitoring parameters including efficacy (eg, resolution/improvement in symptoms); frequency and timing of follow-up

  • Patient education (eg, purpose of treatment, medication administration technique)

  • Self-monitoring for resolution of symptoms

  • Referrals to other providers when appropriate (eg, primary care provider, urgent care)

Implement*

  • Provide patient education regarding all elements of treatment plan

  • Use motivational interviewing and coaching strategies to maximize adherence

  • Encourage patient to return with any questions or contact their provider if their complaint worsens

Follow-up: Monitor and Evaluate

  • Resolution of eye symptoms (eg, redness, pain, excessive tearing)

  • Presence of adverse effects (eg, burning, stinging)

  • Patient adherence to treatment plan

  • Reevaluate if necessary

*Collaborate with patient, caregivers, and other healthcare professionals.

Design a list of questions for a patient who is presenting with complaints of dry eyes. Which medications and/or disease states would you screen when reviewing their medication lists? What would be your initial OTC recommendation for symptom relief? This activity will develop your skills with collect, assess, and plan within the Patient Care Process.

INTRODUCTION

image When it comes to ophthalmic complaints, there are many considerations and other causes to rule out prior to making a pharmacologic recommendation. Patients will sometimes present in the pharmacy or primary care setting with dry eyes, burning eyes, or obstructed vision, or for help selecting appropriate contact lens solutions. While patients may seek a quick cure, the healthcare professional must also realize that a full assessment is encouraged for each patient complaining of symptoms to determine if it is appropriate to use nonpharmacologic or pharmacologic treatments that are available without a prescription or refer to another provider.

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