Red eye in general practice

• conjunctivitis, dry eyes and foreign bodies are the common causes of red eyes in general practice
• treat as an emergency anything you don't come across regularly including iritis, acute glaucoma and ophthalmic herpes. Ophthalmology is a vast subject and delay can quickly lead to a blind eye
• steroids must be avoided unless you are absolutely sure the eye is not infected such as in recurring iritis
• be suspicious of a unilateral red eye - infective conjunctivitis is usually bilateral by the time it presents
• itching is nearly always allergy - Cromoglycate (aqueous) is safe and works well but Nedocromil needs to be used less often
• to instil eyedrops, pull down lower lid especially in children: the lid is much less sensitive than the eyeball
• Chloramphenicol causes aplastic anaemia so extremely rarely
  • can cause allergic blepharitis in chronic use

Chloramphenicol eye drops containing borax or boric acid buffers (boron): use in children younger than 2 years (2)

• following a review of the available toxicological data and a calculation of daily exposure to boron from a typical dosing regimen, it was concluded that the balance between the benefits and risks of chloramphenicol eye drops containing borax or boric acid remains positive for children aged 0 to 2 years
• chloramphenicol eye drops can be safely administered to children aged 0 to 2 years where antibiotic eye drop treatment is indicated

Reference:

1. Drug Safety Update volume 14, issue 12: July 2021: 1.Chloramphenicol eye drops containing borax or boric acid buffers: use in children younger than 2 years