Jan 17, 2011

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Yourenot paranoid if everyone is really out to get you. And youre not narcissistic if the whole world really does revolve around you. At the Dauphin Clinic Pharmacy each pharmacist is periodically assigned to give the staff product education sessions. Last week was my turn. I was to go over eye and ear preparations. When I started explaining the different products, I found it helpful to give examples of how they worked. It turned out all my stories seemed to be about me. More than that, all the stories seemed to be about dumb things Ive done to my eyes and ears and how I had to treat them later. So, lets hit some hi-lights, shall we?

If you go down the dry eye aisle at pharmacy, you will find the most basic eye drop, the artificial tear. It doesnt really have any medication in it. It is mostly water with a stabilizer like hydroxypropylcellulose in it. When you put it on the eyeball, it helps keep the moisture on the eye. There are many, many different brands of artificial tears. Although different people and different doctors will have their favorites, in my opinion the only real difference is whether they have a preservative or not. If an artificial has preservatives, it will be in a single small bottle. The least expensive one in the pharmacy at the moment is simply called Eyelube. If the artificial tear does not have preservatives, it will be in a big box with lots of little individual droppers. My favorite is called Bion Tears. The preservative free drops will be easier on the eye and for some conditions, the eye doctor will insist on them. However, the ones with the preservatives are a nice small bottle, easier to carry around and much cheaper.

Why would someone need an artificial tear without a preservative? Well, one time I had a red eye and decided to treat myself with a prescription antibiotic eye drop. No, I didnt bother to have a doctor look at my eye and write a prescription. I knew what I was doing. The problem was I really didnt have a bacterial eye infection. So although I kept using the antibiotic eye drop, my eye didnt get any less red. So I kept using the antibiotic drop for way too long. It turns out when you do that the preservative in the drops burns little craters into the surface of your eye. So I had to be referred to an eye specialist in Yorkton who, among other things, put me on preservative free artificial tears to help my self-inflicted eye ball craters heal.

What should your do if you have a red eye? If there is pain, see your doctor. If you have lots of pus coming from your eye, see your doctor. If you have lots of watery discharge, but no itchiness, see your doctor. If you have itchy, watery eyes, it could be allergies. With allergies we should first see if we can find the source of your allergy and avoid contact with it. Then oral anti-histamines like Claritin or Reactine are probably my favorite place to start for treating allergy eyes. Failing that, decongestants like Visine with tetrahydrazoline or oxymetazoine can quickly reduce the redness in your eye. The down side to decongestants is if you use them for more than a few days may cause your eyes to get even redder, and decongestants dont fix what caused the allergic eyes. Antihistamine can be added to the decongestant eye drops so you get a dual effect like in Naphcon A which has naphazoline as a decongestant and pheniramine as an antihistamine. As allergy eye drops go, my favorite is Opticrom. Opticrom contains sodium cromoglycate which is a mast cell stabilizer. It stops the kind of white blood cell called a mast cell from releasing histamine and other immune response signals. So Opticrom can stop the allergy eyes from starting. However Opticrom is slow. It may take up to 10 days to be fully effective. It has to be used regularly four times a day to work well. And it works best if it is started before allergy exposure. So ideally you would start taking Opticrom before you go visit your aunt with the cat you are allergic to.

But back to the decongestant eye drops like Visine. What did I mean by if you used it for more than a few days your eyes would get even redder? The effect is called rebound conjunctivitis. It reminds mean of when a friend of mine used too much Dristan nasal spray. Dristan is a decongestant for the nose. So every time she stopped using the Dristan your nose got really stuffed up again. Her nose was addicted to the Dristan. She had to go cold turkey with a really stuffed nose for several weeks before it returned to normal. That is what would happen if you used Visine for more than a couple of days on your eyes. They would stay red whenever you werent using the Visine.

The most common ear problem we get asked about in the pharmacy is wax in the ears. It turns out I get wax build up in my ears. I find it very annoying when I wake up and find my left ear plugged with wax. I cant hear the whole left side of the world. If you have a problem with a build up of wax in your ear, there are some things we can do at the pharmacy, but they are slow. In fact, they are so slow, I usually dont have patience for them. If you want to be able to hear again right away, visit the doctor to have your ears syringed. If you have more patience than me, the cheapest best treatment is oil. Whether you buy mineral oil at the pharmacy or use some olive oil from home, put 3-5 drops into the plugged ear every night. Over the course of 3-5 days, the wax will dissolve and your ears will clear.

So hopefully my misadventures will be educational for you. An like Narcisse, I am going to look at my reflection in this beautiful pool as the world revolves around me.

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

We now have this and most other articles published in the Parkland Shopper on our Website. Please visit us at www.dcp.ca


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