Pharmacists are often at the helm of patient care – offering convenient access to a comprehensive range of services. However, too high a proportion of the population still remain unaware that the sector’s scope extends to help with dry eye syndrome too. SPR chats to two pharmacists about their encounters with the condition, and gauge their advice for providing much-needed relief to distressed individuals.
Gill Harrington, Pharmacy Manager, Right Medicine Pharmacy in Kyle of Lochalsh
How regularly is your advice sought on eyecare concerns?
We are asked advice on eyecare most days of the week, and sometimes several times a day. Some of these queries can be answered by our trained counter assistants but some need input from the pharmacist.
Has this incidence increased over time? Do you think it will continue to change?
We have noticed an increase in these types of query in general and think that this trend can be attributed to several different factors:
• We are situated in an area where there is an ageing population, who may be more prone to getting dry eyes
• There is an increase in the number of people who work regularly using computer screens
• We are a rural region and have extremes of often cold, windy outdoor weather combined with increasingly air-conditioned or centrally-heated interiors
• The number of medications which can contribute to dry eyes is rising, as is the number of patients who have complex pharmaceutical needs to manage their conditions
• A popular young optician has just opened a practice in town, making eyecare more high profile and because we have a good relationship with him, we are able to cross-refer patients between us
• With increased pressure on GP time, many patients are looking to self-medicate where appropriate
With these factors in mind I can only foresee our professional expertise being increasingly in-demand.
What potential do pharmacists represent in helping patients with dry eye syndrome?
Pharmacies are open seven days a week with no appointment necessary so patients can readily access expert advice when they need it. We are able to discuss advantages and disadvantages of the various products and engage with patients to find the most appropriate product for each individual. Pharmacists are able to respond rapidly to more complex situations and advise referral / signpost for more specialist attention to either GPs or opticians.
What leads to the condition’s occurrence?
As previously mentioned, increasing age, computer work, environmental conditions, and medication can be contributing factors. Wearing contact lenses, smoking, alcohol consumption and some medical conditions can also be contributing factors.
Can you describe the treatment process for dry eye syndrome?
General advice for patients would be:
• Keep your eyes clean and don’t rub them
• If you are using a computer screen for long periods, make sure that you take regular breaks and increase your fluid intake
• Use a humidifier or turn the heating down and avoid being in direct line of hot air heaters
• If you wear contact lenses make sure that you allow your eyes to rest by wearing glasses part of each day
• If you think that your medication is causing the problem, arrange to speak to your GP but don’t stop taking the medication meanwhile
More specifically, we would have a conversation about the use of drops and ointments to lubricate the eye. Drops tend to be shorter-lasting and more appropriate during the day, while gels and ointments tend to cause some bleariness and may be more useful at night and in the morning.
An area which is expanding is the use of non-preservative-containing products since information is now being produced about the damage to the eye that can be caused by long-term contact with preservatives. Also, we would have a discussion about whether it was an occasional issue where single-dose unit forms might be appropriate or whether a larger dose container would be appropriate.
We would inform the patients about the importance of avoiding direct contact with the eye and eyelashes and being aware of the 28-day expiry information, and explain about the risks of infection if this is not complied with.
Where appropriate we would be able to supply the products on the Minor Ailment Scheme. Finally, we would invite them to return if they have further issues or if the condition does not improve within a few weeks they may want to speak to their GP.
