common conditions of the eyes & ear

Question 1

AS

Answer 1

left ear

Question 1

AD

Answer 1

right ear

Question 2

AU

Answer 2

each ear

Question 3

OD

Answer 3

right eye

Question 4

OS

Answer 4

left eye

Question 5

OU

Answer 5

each eye

Question 6

A, O, D, S

Answer 6

latin…
A- ear
O- eye
D- right
S- left

Question 7

eye and ear formulation

Answer 7

1 drop- 0.05 ml
suspension= shake well
ointment- can make vision blurry, do not use w/ contact lenses
gel: invert and shake once, get the med to the tip before instilling into eye

Question 8

drugs that increase IOP

Answer 8

• anticholinergics (antihistamines, oxybutynin, tolterodine, benztropine, scopolamine, trihexyphenidyl, TCAs)
• decongestants
• chronic steroids (esp. eye drops like prednisolone)
• topiramate (topamax)

Question 9

glaucoma tx goals

Answer 9

• reduce aqueous humor production
  —> beta- blockers like timolol
  —> Carbonic anhydrase inhibitors, like dorzolamide
• increase aqueous humor outflow
  —> prostaglandin analogs, like latanoprost
• or, do both: often w/ add on tx
  —> alpha-2 agonists, like brimoindine

Question 10

increase aqueous humor outflow

Answer 10

1 drop QHS
bimatoprost
latanoprost
travoprost

darkening of iris and eyelashes, eyelash length can increase

blurred vision, increased pigmentation of iris, eyelash

porst= prostaglandin analog

Question 11

bimatoprost

Answer 11

Lumigan-
Latisse- indicated for eyelash growth- do not sue w/ prostaglandins analogs t indicated for glaucoma
- increase aqueous humor

Question 11

latanoprost

+ netersudil

Answer 11

Xalatan, Xelros
+ Rocklatan
refrigerator before opening
- increase aqueous humor

Question 12

travoprost

Answer 12

Travatan Z

Z- indicates different preservatives used
- increase aqueous humor

Question 13

timolol
+ dorzolamide

Answer 13

timotic
.25% and .5%
+ cosopt

non-selective except betaxolol (betopic)
SE: burning, stinging, Brady/fatigue, bronchospasm
- reduce aqueous humor production

Question 14

carbachol
pilocarpine

Answer 14

miostat
isopto carpinie

SE: poor vison at night due to pupil constriction
- cholinergic (miotic): increase aqueous humor outflow

Question 15

dorzolamide

Answer 15

trusopt
zolamide= be caution w/ suflonamide allergy
acetazolamide- used for the prevention and tx of acute mt altitude sickness
- carbonic anhydrase inhibitors: reduce aqueous humor production

Question 16

brimonidine

+ timolol

+ brinzolamide

Answer 16

lumify (otc) for ocular redness

Combigan

Simbrinza

• adrenergic alpha 2 agonists: increase aqueous humor outflow, reduce aqueous humor production

Question 17

viral conjunctivitis

Answer 17

adenovirus- no topical tx
let infection run it’s course

Question 18

bacterial conjunctivitis
staph aureus
most severe neisseria gonorrhoeae or chlamydia (require systemic tx)

Answer 18

moxifloxacin (Vigamox)
neomycin/ polymyxin B./ dexamethasone (maxitrol)
ofloxacin (ocuflox)
trimethoprim/ polymyxin B (polytrim)

Question 19

allergic conjunctivitis

Answer 19

olopatadine (pataday) otc
ketotifen (alaway, zaditor) otc
azelastine

Question 20

Why do eyedrops burn

Answer 20

• Preservatives such as benzalkonium chloride (BAK)
• contact lenses (put them back in 15 min after not before) BAK can cause eye damage if contact lenses are in
• preservative formulations are available: cosopt PF (PF- preservative free).. z in

Question 21

inflammation

Answer 21

steroids: prednisolone (pred forte, pred mild)
NSAID: ketorolac (acular)

Question 22

Dryness

Answer 22

refresh (otc)
systane (otc)

Question 23

chronic dry eyes disease

Answer 23

cyclosporine emulsions eye drops (Restasis)

Question 24

redness

Answer 24

naphazoline (clear eye redness relief)- otc
naphazoline/ pheniramine (naphcon A, Visine A)
tetrahydrozoline (Visine)- otc

Question 25

common drug known to cause vision changes or damage
Retinal changes/ retinopathy

Answer 25

choroquine
hydroxychloroquine

Question 26

common drug known to cause vision changes or damage
optic neuropathy

Answer 26

amiodarone (plus corneal deposits)
ethambutol
linezolid

Question 27

common drug known to cause vision changes or damage
intraoperative floppy iris syndrome, causes difficulty in cataract surgery

Answer 27

alpha-blockers (tamsulosin)

Question 28

common drug known to cause vision changes or damage
color discrimination

Answer 28

digoxin (w/ tox)- yellow/green vision
PDE-5 inhibitors (sildenafil) greenish tinge around objects
voriconazole- color vision changes

Question 29

common drug known to cause vision changes or damage
vision loss/abnormal vision

Answer 29

digoxin (w/tox)- blurriness, halos
PDE-5 inhibitors- vision loss (one or both eyes; can be permanent)
isotretinoin- decrease night vision (can be permanent), dryness irritation
topiramate- visual field defects
vigabatrin- permanent vision loss (high risk)
voriconazole- abnormal vision, photophobia