Allergic and inflammatory eye conditions Flashcards
If two different eye drops preparations are required
at least 5 minutes should be left between them; ointments should be used after drops.
How to reduce nasolacrimal drainage
Pressure on the lacrimal punctum for at least a minute after applying eye drops reduces nasolacrimal drainage and therefore decreases systemic absorption from the nasal mucosa.
Discard eye drops after
• Eye drops are sterile when they are supplied and should not be used for >4 weeks after opening. In hospital use separate container for each eye to avoid cross contamination + discard after 1 week.
Eye lotions
• Eye lotions are for the irrigation of the conjunctival sac, and act by mechanically flushing out foreign bodies or irritants as a first-aid treatment. These lotions usually consist of sterile sodium chloride 0.9% solution. Clean water will suffice in an emergency
The risk … is increased with contact lenses
• The risk of infection and keratitis is increased with contact lenses; daily lenses are safer. Acanthamoeba keratitis, is a painful and sight threatening condition and is associated with ineffective contact lens cleaning or tap water coming into contact with the lenses. This infection is mainly associated with the use of soft lenses and should be treated by a specialist.
Some drugs and preservative can accumulate in contact lenses when given topically. Many systemic drugs can also cause issues with contact lenses. For example:
- Oral contraceptives (esp. those with high oestrogen) can make contact lenses uncomfortable
- Antihistamines, anxiolytics, hypnotics, and muscle relaxants can reduce the rate of blinking
- Antihistamines, antimuscarinics, phenothiazines + related drugs, some B-blockers, diuretics, + TCAs can reduce lacrimation
- Ephedrine hydrochloride + hydralazine hydrochloride can increase lacrimation
- Isotretinoin can cause conjunctival inflammation
- Aspirin can find its way into tears and accumulate in lenses leading to irritation
- Rifampicin and sulfasalazine can discolour contact lenses.
Contact lenses should be
removed before instillation of the eye preparations and not worn during treatment. Alternatively, unpreserved drops can be used instead.
- However, eye drops can be administered when wearing a rigid corneal contact lenses. Also, ointment preparations should NEVER be used in conjunction with contact lens wear.
Corticosteroids can be administered locally to the eye following
following inflammation or surgery. Topical corticosteroids are applied frequently for the first 24–48h; once inflammation is controlled, the frequency of application is reduced. Use under expert supervision
Three main dangers associated with Corticosteroid eye drops use are:
- Red eye: when undiagnosed, the infection could be caused by the Herpes Simplex virus and a corticosteroid could aggravate the condition, leading to corneal ulceration, possible vision damage or even loss of the eye. Bacterial, fungal and amoebic infections pose a similar hazard.
- Steroid glaucoma: can be caused after the use of corticosteroid eye preparations in susceptible pts
- Steroid cataract: risk of being produced increases with the dose and duration of corticosteroid use
Combination products, containing a corticosteroid and an anti-infective drug are sometimes used after
ocular surgery to reduce inflammation and prevent infection.
allergic conjunctivitis treatment
• Topical antihistamines e.g. Antazoline with Xylometazoline (Otrivine antistin), ketotifen, Azelastine hydrochloride, epinastine hydrochloride and Olopatadine
vernal keratoconjunctivitis + other allergic forms of conjunctivitis treatment
• Sodium cromoglicate + nedocromil sodium eye drops
prophylaxis + treatment of inflammation following surgery or laser
• NSAID eye drops
• for allergies and following surgery.
Diclofenac sodium may be used
used for allergic conjunctival conditions including seasonal allergic conjunctivitis.
• Lodoxamide
