CORRS information for Pharmacists - PSNC Main...
Transcript of CORRS information for Pharmacists - PSNC Main...
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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)
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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?
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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?
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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?
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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?
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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
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Internal –Meibomian
External – Zeiss
Slow onset- self limiting
Hot compress
Chalazion
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Internal – Meibomian
External – Zeiss/Moll
Acute onset, tender, maybe sticky, red
Warm compress, topical Chloramphenicol
Hordeolum
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Scales/flakes
+/- Meibomian dysfunction
On-going treatment Lid hygiene
Warm compress
Tear substitutes
Blepharitis
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Spontaneous, usually
unilateral
Rule out trauma, adenovirus,
Conjunctivitis
Re-assure will resolve
Subconjunctival Haemorrhage
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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
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Pain variable
Mild-moderate redness
History important
Many triggers
Referral for antiviral treatment
Herpes Simplex Virus
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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
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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
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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?