CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian...

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CORRS information for Pharmacists Jane Gray MCOptom BSc Hons PG Cert Eye-care Governance, Prof Cert Glaucoma Clinical Lead PENY&H Ltd (E Yorkshire)

Transcript of CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian...

Page 1: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

CORRS information for Pharmacists

Jane Gray MCOptom BSc Hons PG Cert Eye-care

Governance, Prof Cert Glaucoma

Clinical Lead PENY&H Ltd (E Yorkshire)

Page 2: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

CORRS is a "symptom" based community ophthalmology referral refinement service, provided by accredited optometrists within optical practices.

The symptoms must be:

Of recent on-set.

All patients must be aged 16 years or over

What is CORRS?

Page 3: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Symptoms included are: symptomatic dry eyes

conjunctivitis

symptomatic visual field loss

flashes &/or floaters (<3 months)

in-growing lashes

non penetrating foreign body

painful eye

red/sore eye

epiphora- watering eyes

sudden or recent reduction in vision (<3 months) (i.e. not a gradual change)

What can be seen under CORRS?

Page 4: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Sudden total loss of vision Significant eye pain Significant trauma Chemical burns- all RED require urgent referral to HES Diabetic retinal screening Long term chronic conditions Gradual change in vision which could be attributed to a possible

change in refraction Headaches Diplopia: double vision- all GREEN require sight test Monitoring of conditions e.g. naevi, Ocular Hypertensives, side

effects of drugs e.g. Tamoxifen, Hydroxychloroquine etc., General reassurance

What is not included?

Page 5: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

History and symptoms

Do they require urgent referral?

Do the symptoms fall within the scheme?

Do they require a sight test?

How do you direct customers?

Page 6: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

REDNESS: mild/moderate/severe

PAIN: type, intensity and location

VISION: onset, severity, halos, photophobia

DISCHARGE: none/pus/watery/stringy

Onset: acute/sub-acute/chronic

TRAUMA?

Contact lens wearer?

Previous similar history

History of ocular or general health conditions

Red Eye

Page 7: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Internal –Meibomian

External – Zeiss

Slow onset- self limiting

Hot compress

Chalazion

Page 8: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Internal – Meibomian

External – Zeiss/Moll

Acute onset, tender, maybe sticky, red

Warm compress, topical Chloramphenicol

Hordeolum

Page 9: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Scales/flakes

+/- Meibomian dysfunction

On-going treatment Lid hygiene

Warm compress

Tear substitutes

Blepharitis

Page 10: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Spontaneous, usually

unilateral

Rule out trauma, adenovirus,

Conjunctivitis

Re-assure will resolve

Subconjunctival Haemorrhage

Page 11: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Bacterial Acute onset, bilateral, gritty, burning

Pus-like

Red swollen lid conjunctiva, mild red eye

Adenoviral 3-7 day onset

Highly contagious, acute watering

Gritty, burning, pain, photophobia, red eye

Associated viral symptoms/lymph nodes

Allergic Itching, watery, stringy

Swollen lumpy lids, pink glassy conjunctival

Atopic

Conjunctivitis

Page 12: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Pain variable

Mild-moderate redness

History important

Many triggers

Referral for antiviral treatment

Herpes Simplex Virus

Page 13: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Benign, recurrent, unilateral,

inflammation of vasculature

20-40 years & female

Tender

Vision unaffected

Self limiting

NB: SCLERITIS affects more elderly with systemic health problems

Episcleritis

Page 14: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Inflamed iris &/or ciliary body

Unilateral, rapid onset

Moderate-severe deep periorbital pain

Photophobia, lacrimation

Hazy vision

Miotic pupil

Circum-limbal injection- purple red colour

Acute Anterior Uveitis

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IOP due to obstruction

Aqueous flow

Extreme pain

Blurred vision

Acute Angle Closure Glaucoma

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Benign or sight threatening?

PVD increased prevalence-

50-70 years

RD and tears risk groups:

myopic

Trauma

Ocular surgery

Ocular inflammation

Flashes and Floaters

Page 17: CORRS information for Pharmacists · 2016. 1. 27. · Hordeolum Scales/flakes +/- Meibomian dysfunction On-going treatment Lid hygiene Warm compress Tear substitutes Blepharitis Spontaneous,

Confirm their GP surgery

Sign post the patient to optometry practices providing the service for their surgery CCG

List is provided

Advise the patient to contact their preferred practice

If the customer’s GP is outside the area, but they live in the CCG area they are not eligible to access CORRS

How to access CORRS?