Rick O’Shea comes to your pharmacy to pick up a refill on his fluticasone inhaler. He also asks what is good for his bloodshot eyes. Pertinent history includes his love of dirt biking in the desert, which he does every evening after work, plus his nightly swim at the YMCA. He also complains of a recent onset of joint pain in his hands. Upon observation you notice mild diffuse inflammation of both conjunctivae, no discharge, and small yellowish patches at the 3- and 9-o’clock positions in both eyes.

1. List two possible causes for Rick’s bloodshot eyes. Explain your rationale.

2. List three questions that you would ask to help determine the cause of Rick’s inflamed eyes. Explain your rationale.

3. List three questions you would ask to make sure this was not a vision-threatening condition that required immediate referral.

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