Case Study 2 — Get the right treatment for your red eye

A young lady in her 20s came to see us recently after having a sore red eye and blurred vision for about 5 days. She had been using the common over-the-counter antibiotic eye drop Chlorsig, typically used for a mild case of bacterial conjunctivitis (pink eye).

This was the appearance of her eye on presentation:

This young lady did not have conjunctivitis; she had a classic case of an eye condition called anterior uveitis, or iritis. It is an inflammatory condition of her iris, the coloured part of the eye that controls the pupil. It is a relatively uncommon condition that can affect a person of any age, typically a young to middle-age person. Symptoms usually include increased sensitivity to light (photophobia), eye pain or ache, redness in the eye, blurred vision and one pupil appearing smaller than the other.

​Optometrists can diagnose anterior uveitis, and differentiate it from other kinds of pink eyes, by detailed examination of the eye with our slit lamp microscope.

The necessary treatment for this condition is immediate and rapid control of the inflammation with a intense course of steroid eye drops (prednisolone acetate — Pred Forte) — typically every 15 minutes in the first 6 hours, then hourly dosing while awake, and reviewed the following day. A strong pupil dilation eye drop (eg. atropine) is also used to keep the pupil enlarged to prevent the inflammed iris from sticking to the front of the eye's natural lens (posterior synechiae). In this case as the iris had already adhered to the lens she had some permanent damage to her iris and pigment spots left on her lens. If this kind of eye inflammation is left untreated or not properly managed, vision loss and glaucoma (high eye pressures causing optic nerve damage) can result.

With our treatment of strong steroid eye drops and pupil dilation drops she had relief from her eye pain within a short period of time. And at her next-day follow up the inflammation and redness had already subsided significantly with treatment. After continuing with treatment and allowing the inflammation to completely resolve, we referred her to see her GP for blood tests as anterior uveitis is a eye condition that has a strong association with other systemic inflammatory or autoimmune disorders.

The take-home message from this case is that if you have a concern about your eye, please see an eye care professional who can make a sound clinical diagnosis and give you the treatment you need right away.

​​Not all pink eyes are common conjunctivitis — if you have a painful (more than just an irritation) red or pink eye, light sensitivity or blurred vision you should see either a therapeutically-endorsed optometrist (an optometrist who is trained and qualified to prescribe medicines) or an ophthalmologist (eye specialist) without delay. And if you've been using an antibiotic eye drop such as Chlorsig for a pink eye but it doesn't show improvement, please seek further opinion for your eye promptly.

For an after hours emergency or if you are unable to find a suitable eye care practitioner, the Royal Victorian Eye & Ear Hospital in East Melbourne would be the place to go.
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EYECARE CONCEPTS — THERAPEUTIC OPTOMETRIST — KEW EAST, MELBOURNE
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