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Dry eyes

Dry eyes are a common cause of presentation for MECS (Minor eye conditions service) appointments, with a wide variation in patient symptoms.

Mostly but not exclusively: gritty or foreign body (something in the eye),

                                                Itching, burning or red eyes worsening throughout the day,

                                                Blurred vision – more frequently when reading or concentrated tasks,

                                                Watery eyes – worse during windy or air-conditioned environments,

                                                Generally, in both eyes – usually one eye is worse than the other.

There are a wide range of factors that predispose a person to dry eyes; women are more likely to be affected by dry eyes more than men and is also more common in the later decades.

Systemic illnesses such as thyroid disease or arthritis and other inflammatory conditions can make a person more likely to struggle with dry eyes, other atopic conditions such as psoriasis, rosacea and eczema may also increase symptoms in some patients. Along with contact lens wear – particularly in patients who over wear their lenses.

Patients under treatment with topical eye medications long term may have also experience an increase in dry eye symptoms over time, where possible patients should be offered preservative free treatments to reduce this.

Dry eyes can be roughly split into 2 categories: Aqueous dry eye deficiency and Evaporative dry eye.

Aqueous dry eye deficiency is where the gland producing the watery component of the tear film is not producing sufficient fluid to adequately cover the eye surface leading; in severe cases this may be diagnosed as Sjogren syndrome if associated with rheumatic conditions.

Evaporative dry eye is where there is enough fluid to cover the eye being produced but it is not retained on the eye surface, this may be due to the top oily layer of the tears being deficient. This can be associated with blepharitis.

Several treatment options are available in practice such as Eyebag hot compress and lid massage which can help to improve the quality of the oily layer of tears and therefore reduce symptoms. Various tear supplements are available for day and night use, gels are predominantly used at night to help stop evaporation whilst sleeping. Lipid sprays can be useful for patients with evaporative dry eye during the day also. Regardless of the method of treatment chosen these should be preservative free.

Other treatments include blocking the drainage channels in the corner of the eyes to ensure tears stay in the eyes.

In severe cases once these options have been exhausted it may be necessary to refer patients the hospital eye service for further treatment options.

It is important for patients with dry eye to understand that this would be a life-long treatment as in most cases dry eye symptoms will return if the patient stops the recommended treatment, this should become a part of a patients daily routine.

Bacterial conjunctivitis

Bacterial conjunctivitis – a condition that most adults will have experienced either themselves or through their children!

The vast majority of patients presenting at our MECS appointments with bacterial conjunctivitis are children from the age of 3.

Classic presentation includes lashes that are stuck together on waking in one or both eyes, sticky mucus discharge and mild redness of the clear tissue overlying the white of the eyes (conjunctiva).

Causes of bacterial conjunctivitis can be from outside contamination, other people you come into contact with or from the environment. Some patients will suffer with bacterial conjunctivitis following a cough or cold. Another cause could be build-up of oils on the lashes which makes you more prone to infection, a condition called blepharitis which is generally more common in the elderly.

More often than not where children are concerned, parents are advised they cannot attend school or nursery as the condition is contagious. It will please parents immensely to know Public Health England DOES NOT require exclusion from education for this condition, but does advise family members to use separate towels and so forth at home. We’ll leave you to take this up with your children’s school though!

Bacterial conjunctivitis is usually a self-resolving condition that can be treated at home by bathing the eyes in boiled sterile water or saline solution, at least twice a day. Most patients will NOT require antibiotic eye drops/ ointment unless the practitioner feels that there is significant discharge on examination or the condition has not resolved 1 week from onset.

Be patient and ‘keep an eye on it’, all puns intended! If it doesn’t improve within 1 week we’ll be more than happy to see you and offer further help and advice.

Optometrists cannot write prescriptions to the same extent as a doctor unless they hold a specialist qualification. We can write a ‘Written order’ to a pharmacist for a small number of drugs for common eye conditions, such as bacterial conjunctivitis, allergic eye problems and dry eyes.

Special cases:

Babies with sticky lashes should be seen by a GP as we CANNOT prescribe antibiotics to children under 3, it may not be conjunctivitis in this case and should be seen by a doctor.

Patients who are contact lens wearers with similar symptoms should be more cautious as the bacteria causing the infection may be from a foreign source and therefore require different treatment – Please come and see us!

For further information please visit the college of optometrist website: https://www.college-optometrists.org/guidance/clinical-management-guidelines/conjunctivitis-bacterial-.html

M.E.C’S

MECS – Minor Eye Conditions Service, but what does that mean for you?
MECS is a way for local optometrists to manage eye conditions in practice without patients having to
see their GP or visit A and E; in order to qualify for a MECS your symptoms must be of sudden onset
or within the last 3 months.
MECS can apply to any of the following symptoms:
 Red/ sore/dry/watery eyes.
 Discharge from the eyes.
 Itchy eyes.
 Painful/ light sensitivity.
 Flashing lights and floaters.
 Sudden loss or reduction in vision.
 Visual aura/ migraines.
 Double vision.
 Contact lens related problems.
And many more!
A member of our reception staff will run through a series of questions which make up a triage form
in order to decide how soon you need to be seen under MECS or whether you require a normal eye
examination. Either way we’ll do our best to book you in as soon as possible.
At Flint and Partners Optometrists new or existing patients enquiring about the MECS service will
ideally be seen within 48hrs where possible at one of our 3 practices.
At the time of booking you appointment you will be advised on whether you can drive to your
appointment. In some cases, drops which dilate the pupil may be required in order to aid diagnosis
you cannot drive following application of these as your vision will be blurred…….no really!
Where possible the optometrist will advise if your condition can be managed at home by yourself
with drops or if it requires management at all. In cases where a referral is required you will be
advised of the estimated waiting time for the appointment at the Hospital Eye Service (HES), this
depends of the severity and type of the condition.
70% of patients seen under the MECS scheme do not require further appointments and are
discharged after their first visit. Only approximately 10% of patients require urgent referral to HES.

Gucci Sunspecs

Gucci Sunspecs

A timeless Gucci sunglass design arrived from Italy 🇮🇹 . With the “record breaking February temperatures” set for the uk this weekend,
you may want to pop into any of our three branches, Tettenhall,Codsall and Wednesfield and treat yourself! Call 01902 422096 and our lovely reception team will be happy to help

School Vision

School Vision

This handsome chap is Henry. Henry was prescribed some fabulous blue lenses through our School Vision Assessment with our Optometrist Keren.

It is very important to look after your eyes from a young age. School vision takes this care one step further; it is not only a health check but means of improving a child’s performance at school.

The Senaptec Sensory Station

The Senaptec Sensory Station

The Senaptec Sensory Station is a computerised solution for enhancing sensory skills, which Ed Lyons has customised for his sports vision consultations. Here we are designing training programs for a Premier League footballer and a client with her sights set on the Tokyo Olympics in 2020! Sports vision consultations are now booking up to June with limited availability. Call on 01902 422096.