The CMGs offer information on the diagnosis and management of a range of conditions that present with varying frequency in primary and first contact care.
Phthiriasis is an infestation of lid margins by blood-feeding crab lice. It causes itching, redness, madarosis, petechial macules, and blepharoconjunctival hyperaemia and oedema. The condition is usually sexually-acquired, but can also be contracted within families through poor hygiene and close contact. This Clinical Management Guideline outlines the aetiology, signs and symptoms and evidence-based recommendations for diagnosing and treating phthiriasis. It includes non-pharmacological management approaches, pharmacological treatment options, and highlights the need for GP referral for management of non-ocular aspects including screening of close contacts and discussion of potential safeguarding issues in the case of children.
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What is phthiriasis?
This condition is caused by infestation of the eyelashes by the crab louse, which is usually acquired by sexual contact.
Phthiriasis causes the eyelids to become itchy and the eyes to become red and watery. It may be possible to see the eggs of the lice (called nits) clinging to the bases of the eyelashes.
How is phthiriasis managed?
The treatment involves removing the lice and nits at the slit lamp (the clinical microscope used by optometrists and ophthalmologists). Pubic infection can be treated with drugs available without prescription from pharmacies. Patients are advised that they have a sexually transmitted condition and that family and partner(s) may need to be examined also. Bed linen, towels and clothes should be washed at 60°C for at least five minutes.