Age Related Macular Degeneration, Dry Eye and Mouth

Question 1

What is ‘wet-active’ age-related macular degeneration?

Answer 1

Neo-vascular age related macular degeneration:

new blood vessels develop within the retina, and can lead to a rapid deterioration of vision.

Question 2

What is the first line treatment for wet-active age related macular degeneration?
What have a visual acuity less between 6/12 and 6/96

Answer 2

Intravitreal anit-vascular endothelial growth factor e.g.:
Ranibizumab
Aflibercept
Bevacizumab

Question 3

For Dry Eye, what is the most frequently used treatment for tear deficiency in patients with mild dry eye?

Answer 3

Hypromellose:

Hourly and then reduced frequency after adequate symptom relief.

Question 4

What are 2 suitable alternatives for hypromellose in patients with dry eye?

Answer 4

Carbomers and polyvinyl alcohol
Carbomers may be less tolerated than hypromellose because its thickness has an impact on vision, but also decreases the frequency of application

Question 5

What should ocular lubricants contain that can be used for moderate to severe dry eye following a suitable trial (6-8 weeks) of treatment options for mild dry eye.

Answer 5

Ocular lubricants containing
sodium hyaluronate
hydroxypropyl guar or
caramelose sodium

Question 6

What simple measures can be taken for dry mouth?

Answer 6

Frequent sips of unsweetened drinks, sucking pieces of ice or sugar free pastilles or chewing sugar free gum?

Question 7

What can be given to patients who have xerostomia (dry mouth) following irradiation for head and neck cancer?

Answer 7

Pilocarpine

- May take up to 3 months to be effective.