Differential Diagnostic Indicators for the Appointment of Non-Steroidal Anti-Inflammatory Therapy in the Treatment of Red Eye Syndrome at the Stage of Primary Outpatient Admission. Part 2

Abstract

In recent years, the Delphi method (DMt) has been widely used in scientific practice. It is based on an expert assessment of the object under study, which is formed on the basis of a survey of a group of experts in a particular field. The application of the Delphi method in various areas of ophthalmological practice has made it possible to develop practical recommendations for the diagnosis of visual stress, methods for diagnosing and treating keratoconus, to develop clinical guidelines for the diagnosis and treatment of patients with Sjögren’s syndrome, to classify the signs and symptoms of dry eye syndrome in accordance with the main mechanism of its occurrence and etc. A survey ophthalmologist expert conducted during the study, performed in accordance with the Delphi method, aimed at developing a differential algorithm in the treatment of patients with one of the most common pathologies among diseases belonging to the category of “red eye syndrome” — conjunctivitis, allowed identify key symptoms for prescribing different groups of drugs. In accordance with the clinical guidelines developed by the Russian Association of Ophthalmologists, the following groups of drugs are recommended for use: antibacterial, antiseptic, antihistamine, non-steroidal anti-inflammatory drugs, steroidal anti-inflammatory drugs, antiviral drugs. This article presents the results obtained in determining the indications for the use of non-steroidal anti-inflammatory therapy in the treatment of conjunctivitis. These include: the presence of a history of systemic diseases, the duration of inflammation for more than 7 days, the absence or presence of mucous discharge, complaints of a feeling of pain, discomfort in the eyes, their redness, as well as biomicroscopic signs of inflammation, which manifest themselves as mild to moderate conjunctival hyperemia expressiveness. The result obtained is of fundamental practical importance for primary outpatient ophthalmologists for choosing rational drug therapy in the treatment of one of the most common pathologies encountered in ophthalmic practice — conjunctivitis. A differentiated approach in choosing the volume and type of drug therapy based on the severity of the inflammatory process will reduce the drug load on the ocular surface. In accordance to the data presented in the first part of this article, it will lead to a decrease the risk of developing signs of dry eye syndrome against the background of a stopped inflammatory process in the long-term period and improving the quality of life in patients.

Keywords

• ophthalmology
• dry eye syndrome
• red eye syndrome
• eye pain
• eye discomfort
• delphi method
• algorithm