Eye problems and shit Flashcards

1
Q

Dry Eye Causes

A
  • Aging
  • Various disease (RA, Bells Palsy)
  • Eye anatomy defects
  • Medications (anticholinergic, decongestants, diuretics, beta blockers)
  • Environmental conditions
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2
Q

Dry Eyes Clinical Presentation

A
  • White/mild red eye
  • sandy/gritty feeling
  • initial presentation with excessive tearing
  • “feels like something is in my eye”
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3
Q

Nonpharmacologic Treatment for Dry Eyes

A
  • • Cold compress
  • • Omega 3 FA, flax seed oil (oral)
  • • Avoidance of environments that increase tear evaporation
  • • Avoid computer strain
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4
Q

Pharmacologic Therapy For Dry Eyes

A
  • Nonmedicated Ointments are mainstay of treatment
  • Blurred vision
  • Artificial tears – stabilize the tear film, protect, decrease tear evaporation, enhance wound healing; provide lubrication
  • Lubricants and vehicles
  • Vehicles they increase drug action by decreasing drainage due to increase viscosity to increase contact time
  • Cellulose esters (hydroxypropyl methylcellulose)
  • Polyvinyl alcohol (PVA)
  • Povidine
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5
Q

Artificial Tears

A
  • Systane
  • Refresh
  • Optive, Clear Eyes for dry eyes
  • GenTeal
    • Less Preservatives is better
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6
Q

Systane

A
  • Polyethylene glycol + propylene glycol
    • gelling and polymer system lubricant eye drop; creates and ocular shield
    • Promotes comfort and relief of symptoms
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7
Q

Refresh

A
  • CMC sodium 0.5% and 1%
  • Glycerin, polysorbate 80, & castor oil
  • Oil-in-water emulsion; prolonged lubrication
  • bid-tid; can use with artificial tears
  • vehicle in Restasis
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8
Q

Optive, Clear Eyes for dry eyes

A

CMC sodium + glycerin

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9
Q

GenTeal

A
  • CMC sodium + hypromellose
  • Moderate to severe dry eye
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10
Q

Refresh Optive Advanced Lubricant

A
  • Components: glycerin (0.9%), polysorbate 80 (0.5%), CMC 0.5%, boric acid, castor oil, erythritol, levocarnitine, and carbomer copolymer type A
  • Lipid-based, triple-action preparation that helps lubricate and hydrate dry eyes and protects against evaporation of natural tears
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11
Q

Nonmedicated Ophthalmic Ointments

A
  • White petrolatum(lubricant and ointment base); mineral oil (helps ointment melt at body temperature); lanolin (facilitates incorporation of water soluble medication and prevents evaporation)
  • Advantage – enhance retention time in eye
  • BID dosing (Qhs mostly)
  • SE: Blurred vision
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12
Q

Preservatives

A
  • Surfactants – bactericidal (disrupt bacterial membrane)
  • Mercury metals (thimerosal); iodine; EtOH
  • Benzalkonium chloride (BAK)
  • Long term use can cause damage to conjunctival and corneal epithelium
  • Sodium perborate – dissociates upon contact on eye to form hydrogen peroxide (small amt)
  • Purite (oxychloro complex) – dissociates after long wave UV light to form water and sodium
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13
Q

Excipients

A
  • Antioxidants – prevent/delay deteriation of products exposed to oxygen
  • Wetting agents – decrease surface tension and low drug to spread easily
  • Buffers – maintain pH between 6-8 (decrease ocular discomfort)
  • Tonicity adjusters – helps medications to be isotonic with physiologic tear film
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14
Q

Allergic Conjunctivitis

A
  • Type I IgE-mediated hypersensitivity reaction
  • Immediate Response – predominately by mast cells -> histamine is the main mediator w/ H1 and H2 receptors involvement
  • Late phase – mast cells release other cytokines and chemokines causing continuation of inflammation -> eosinophils, basophils, and neutrophils appear in 6-10 hrs after exposure followed by others
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15
Q

Exclusions to Self-Care for Allergic Conjunctivitis

A
  • } Eye pain
  • } Blurred vision not associated with use of ophthalmic ointments
  • } Sensitivity to light
  • } History of contact lens wear
  • } Blunt trauma to the eye
  • } Chemical exposure to the eye
  • } Symptoms that have persisted >72 hours
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16
Q

Pharmacologic for Allergic Conjuntivitis

A
  • Artificial tears
  • Ophthalmic decongestants
  • Ophthalmic antihistamine/mast cell stabilizer
  • Antihistamine/decongestants
  • Oral antihistamines
17
Q

Ophthalmic Decongestants

A
  • MOA: primarily on α-adrenergic receptors to constrict conjunctival vessels and decrease eye redness
  • Duration of use is 72 hours
  • Can produce rebound conjunctival hyperemia