The Eye – When to Relax and When to See a Doctor!

A red and inflamed eye is a very common presentation in pharmacy but it can also become quickly
dangerous. The most common culprits causing a red eye in pharmacy are the three types of
conjunctivitis and benign causes such as lack of sleep, prolonged screen time, smoke exposure and
direct irritation. These are not significant issues and can be treated over the counter. There are,
however, some worrying conditions that can progress rapidly and lead to lasting visual impairment.
It is our job as pharmacists to pick out when we can help you instore and when there is a nastier
cause that needs further evaluation.

The most important red flag that we look for is a painful eye. Conjunctivitis is irritating, looks like an
eyesore – pun intended – and can be sharp and scratchy, however it will not cause a dull ache or
pain. This usually means that there is a deeper cause leading to a raised pressure deeper in the eye
(such as glaucoma or a bleed into to posterior chamber of the eye). This always needs to be
investigated further, either by an optometrist or in the emergency department of a hospital.

Another red flag is visual changes. If there is blurred vision or a blind spot, this again needs urgent
follow up. Other things to look out include increased sensitivity to light, symptoms lasting longer
than 1 week or if your eye is red and you are currently taking blood thinners such as warfarin or one
of the novel oral anticoagulants.

Red Flags! When to go straight to the doctor

  • Painful or Aching Eye
  • Blurred Vision
  • Sensitivity to the light
  • Not responding to treatment
  • Symptoms that have lasted for a full week
  • Red Eye in somebody taking blood thinning medications

We can however help with conjunctivitis. The stereotypical sticky, yellow eye that most people
associate with conjunctivitis is a type of bacterial infection. We can provide antibiotic eye drops or
ointment to help with this.

There is also an allergy-based conjunctivitis which usually causes an itchy, watery and red eye. It can
be associated with the other allergy symptoms such as rash and a runny nose. This can be treated
with saline, lubricating eye-drops or an antihistamine eye-drop.

Viral conjunctivitis is the last type of conjunctivitis. This appears similar to an allergic cause but isn’t
itchy. Best treatment is with cold compress and lubricating eyedrops. There is no reason to use
antibiotics for either viral or allergic conjunctivitis and it is our responsibility as pharmacists to
ensure that there is a therapeutic need before dispensing antibiotics. This will help ensure that the
bacteria don’t become resistant and that the drops will keep working in future when they are