Eye Lecture 1 Flashcards
Topical drug dellivery - eye drop considerations
limited volume capacity
- tear volume = ___ - ___ microliters
- volume delivered by eyedropppers = ___ - ___ microliters
Built in defense mechanisms
- sudden increase in tear volume - rapid blinking reflex
- corneal proteaction barrier
Residence time
- drug reside in the conjunctiva for about ___ - ___ min
Topical drug dellivery - eye ointment considerations
drug depot
- serves as a drug depot in the conjunctival sac resulting in enhances/sustained absorption
Blurry vision
- blurred vision is often reported after administration and can last up to ___ min
chanllenging to apply
- difficult to apply exact dose. Directions often say to apply in inches
Eye drop administration
- wash hands and remove contacts if applicable
- while tiliting your head back, pull down the lower lid of you eye to form pocket
- hold the dropper with the other hand, as close to the eye as possible without touching
- squeeze the dropper so that a single drop falls into the pocket
- remove index finger from the lower eyelid. Close your eyes for 2-3 minutes and tip your head down towards the floor
- place finger onf the tear duct and apply gentle pressure
1) wash hands and remove contacts if applicable
2) holding the tube between your thumb and forfinger, place it as neat to your eyelid as possible without touching
3) while tilting your head back, pull down the lower lid of your eye with your index finger tp form a pocket
4) squeeze ribbon of ointment or gel into pocket
5) remove index finger from lower eyelid. Blink gently then close your eye for 1-2 minutes
6) wipe and excess ointment from the eyelids/lashes. Wipe tip of tube clean.
Bacterial Conjunctivitis - Presentation
- redness, yellow, white, or green discharge
- eye is stuck shut in the morning
- typically unilateral
- highly contagious
Bscterial conjuctivitis - Treatment
Non-PCOL
avoid sharing towels, cosmetics, linnens
remove contact lenses - do not resume wearing until eye is white and there is no discharge for 24 hours after antibiots
PCOL
- often self limiting in most cases; topical antibiotics may shorten the clinical course
- antibiotic treatment required in contact wearers
- ointment preferred over drops in children/risk of poor compliance
Bacterial Conjunctivitis - Antibiotics
erythromycin 5 mg/g oint
- dose: 0.5 inch strip, QID
moxi
oflo
trim
Viral Conjunctivitis
Presentation
- watery eyes
- buringin, sandy, gritty feeling in eyes
- pus is morning crusting followed by watery discharge throuhgout the day
- other eye often involved within 24-48 hours
- part of viral upper respiratory infection
- highly contagious
common cause:
- adenovirus
Viral Conjunctivitis - Treatment
Non-PCOL
Symptomatic Relief Only
- warm or cool compress
- topical decongestant - limit duration of use to avoid rebound congestion
Viral conjunctivitis - Decongestants (OTC)
naphazoline 0.012-0.2% solution
Viral conjunctivitis - Decongestants (OTC)
tetrahydrozoline 0.05% solution
Allergic Conjunctivitis - presentation
- redness, watery discharge, itching
- may have morning crusting
- both eyes often involved
- accompanied by other allergic symptoms; nasal congestion, sneezing, wheezing
- eye rubbing can make symptoms worse
Common causes:
- airborne allergens
Allergic Conjunctivitis - Treatment
Non-PCOL
PCOL
Allergic Conjunctivitis - Antihistamines
olopatadine
Allergic Conjunctivitis - Antihistamines
azelastine
Allergic Conjunctivitis - Antihistamines
epinastine
Allergic Conjunctivitis - Mast Cell Stabilizers (Rx)
cromolyn sodium
Allergic Conjunctivitis - Mast Cell Stabilizers
lodoxamide
Allergic Conjunctivitis - Mast Cell Stabilizers
nedocromil
Allergic Conjunctivitis - Multi-acting agents (OTC)
ketotifen
Allergic Conjunctivitis - Multi-acting agents (OTC)
alcaftadine
Uveitis
Uveitis - intraocular inflammation
Pressentation
- pattered (wagon wheel) redness associated with iritis
- dilated pupil
- complains of disconfort and sensitivity to light
Treatment
- topical glucocorticoids
- mydratic/cycloplegic
ophthalmic steroid strengths
Uveitis - treatment considerations
referral to ophthalmologist/optometrist for treatment
treatment ___ - ___ weeks
ophthalmic steroid toxicity: 2nd infections, secondary open angle glaucoma
increase in intra ocular pressure (IOP)
normal IOP = 12-20 mmHg
- 5% of population demonstatres an IOD increase > 16 mmHg
- 30% of population demonstrates increase of ___ - ___ mmHg
- risk factors - primary open-angle glaucoma, oculat hypertension, elderly, children
Macular Degeneration
top risk factors: smoking and age
dry
- > 50 YO
- 90% of MD cases
- usually both eyes affected
- gradual loss of vision
wet
- advanced
- vision loss may be rapid
- loss of central vision due to abnormal growth of new blood vessels
Leading cause of blindness
treamtnet goals - slow progression and prevent severe visual impairment or blindness
Macular Degeneration - Rx treatment
VEGF inhibitors
- VEGF is important for the formation of new blood vessels and vascularization of tissues
- inhibitors are antineoplastic agents
Dry eyes
causes decreased tear production
- ___ syndrome: autoimmune disease characterized by lymphocytic infiltration of the exocrine glands resulting in xerostomia and dry eyes
- increased evaporative loss
presentations: dryness, red eyes, general irritation, gritty sensation, blurred vision, light sensitivity
risk factors: advances age, female sex, contact lens wearers, low humidity environments, medications
dry eyes - treatment
dry eyes - tear supplementation
