By Dr Spiro Doukakis MBBS, FRACGP, General Manager of Clinical Governance, SA
When practising medicine in the after hours, as I have done for more than twenty five years now, it always surprises me how many patients I am called to see with acute eye complaints or injuries.
Conjunctivitis
Conjunctivitis (sometimes called “pink eye”) is a very common complaint, particularly amongst toddlers and school-aged children, because both the bacterial and viral forms of it are extremely contagious.
Bacterial conjunctivitis is characterised by a yellow or green discharge, red congested eyes and stickiness to the eyelids. Treatment with antibiotic eye drops is required to eliminate the bacteria.
Viral conjunctivitis often accompanies other viral illnesses such as colds, flu and measles. It is spread by airborne viruses – typically from sneezing and coughing. Viral conjunctivitis usually produces a watery discharge, and quickly spreads from eye to eye. For viral conjunctivitis, antibiotics do not work. Eye drops can help ease the symptoms, but the virus is self-limiting, which means it will resolve by itself after a few days.
The symptoms for allergy or pollen-related conjunctivitis are similar to those of viral conjunctivitis, but usually with other hay fever-like symptoms such as itchy eyes, congestion, sneezing, swollen eyes and sensitivity to light. Allergic conjunctivitis is not contagious, and it can be treated with antihistamine drops or oral antihistamine medication.
Conjunctivitis can last from two days to two weeks. You should stay home from work, and children should be kept home from school or day care while the infection is active.
Foreign bodies in the eye
Another common scenario is when somebody gets something stuck in their eye. A foreign object may enter the eye at work in the machine shop or sawmill. It may happen during dry, windy conditions, or perhaps during weekend outdoor activities such as gardening, DIY or sport. It may even involve an accident with saws, drills or lawnmowers.
Flying debris can get lodged in your eye – a speck of dust, a wood chip, grass clipping, insect or even a piece of glass.
If this happens you should see your doctor immediately. If it is after hours, call 13SICK, or go to the Emergency Department for help.
Patients naturally feel a sense of panic when they have something in their eye, so it is important to keep calm. Do not attempt to forcibly remove any foreign object from the eye. Try flushing gently with general saline to remove any dirt or grit. Do not apply any creams or drops before being seen by a doctor.
In superficial cases, the doctor can help by removing any foreign object found floating on the surface of the eye, or underneath the eyelid, with a cotton bud tip and a steady hand and a little anaesthetic eye drops.
If the foreign body is central or deep, the doctor will refer you to see an ophthalmologist (specialist eye doctor). For more serious cases, where a foreign object may be embedded in the cornea, the patient should attend the Emergency Department for removal under controlled conditions.
After the procedure, you may need to use drops or ointment to prevent infection. Be sure to follow the instructions and continue the treatment until your eye has healed.
Prevention
To prevent eye accidents from happening, wear safety glasses when mowing, gardening or using machinery, especially when working in windy or dusty conditions.
13SICK can help
If you’re worried about an injury or eye condition, it is best to seek help immediately from your GP or eye doctor. If it’s an emergency, you should go straight to hospital. If it’s urgent, and you need a doctor on weeknights and weekends, when GPs and eye doctors are closed, you can call or click 13SICK for an after hours home doctor visit.
Dr Spiro Doukakis MBBS, FRACGP is General Manager of Clinical Governance (SA) at 13SICK, National Home Doctor Service. He has more than 25 years’ experience both as a General Practitioner and a visiting home doctor, with a special interest in urgent medical care.