1. Eye *complete* Flashcards
Eye preparations application
Leave 5 min gap between eye preparations to prevent drug dilution and the eye overflowing.
Longer intervals will be needed for gels as they are more viscous and willl take longer to be absorbed.
Ointments should be applied last as they take the longest
Eye prepations counselling
Transient blurred vision common with eye preparations. More with eye ointements for up to 10-15 minutes. So are applied at bedtime for this reason.
Eye preparations expiry dates
Home use - 28 days
Hospital/ward - 1 week
Outpatients/surgery - single application
Preservatives in eye drops
Benzalkonium chloride commonly used. Can cause stinging and irritation especially at first application.
Eye drops and contact lenses
- Hard lenses - can still use eye drops whilst wearing the lenses
- Soft lenses - must remove lenses before using eye drops OR can use preservative-free eye drops as preservatives accumulate in soft lenses
- Lenses should NEVER be worn when applying eye ointments/oily eye drops.
Drugs and contact lenses considerations
Rifampicin and sulfasalazine stain bodily fluids such as tears, this stains contact lenses orange
Allergic conjuctivitis
Caused by allergies
Allergic conjuctivitis treatment
- Sodium cromoglicate (mast stell stabiliser)
- Antazoline, Azelastine (antihistamine)
- Xylometazoline, Naphazoline (vasoconstrictors reduce redness)
Dry eyes
Treated with tear replacement
Hypromellose - applied hourly
Carmellose - applied QDS
Thicker formulations such as carbomer gels are more moisturising and reduce frequency of application
Bacterial conjunctivitis
Chloramphenicol eye drops/ointment
Viral conjunctivitis associated with herpes simplex virus
Viral conjuctivitis usually caused by cold/flu which is self limiting. However if it is associated with herpes simplex virus can use….
Aciclovir: 5 times daily and until 3 days after healing
Blepharitis
Chloramphenicol can be applied to the lid margins to help.
If pus is present it may be a stapphylococcal infection - fuscidic acid would treat it
Eye inflammation and topical steroids
Topical corticosteroids are used to reduce inflammation BUT have following side effects:
* glaucoma and cataracts
* increase susceptibility to infections and aggravating existing infections
Can lead to corneal ulcers and red eye if used improperly, when the cause of the eye inflammation is not treated
Corneal ulcers = DANGEROUS, as they can lead to blindness.
Corneal ulcers treatment
Intensive antibiotic course with ciprofloxacin administered every 15 minutes for the first 6 hours
Eye examinations/procedures
Cycloplegics/Mydriatics are used to dilate the pupils for eye examinations
- Antimuscarinics such as atropine
- Phenylephrine
Phenylephrine interacts with MAOI antidipressants. Should not be used in patients taking this due to risk of hypertensive crisis.
Patients should not drive until visiion is clear