EYES (NEW)

Question 1

How are eye drops administered?

Answer 1

• Into the pocket of the eye, by pulling down the eyelid
• Keep the eye closed as long as possible after administration

Question 2

How is eye ointment administered?

Answer 2

• Spread line of ointment into the pocket of the eye, by pulling down the eyelid
• Blink to spread
• Can get blurred vision for the next 5 mins

Question 3

How to administer local injection into the eye?

Answer 3

• Usually used when higher drug concentrations are required
• Subconjunctival injection
• Intracameral route
• Intravitreal route

Question 4

If two different eye drops are being used on the same day, can they be used at the same time?

Answer 4

• No, since dilution and overflow may occur when one immediately follows the other
• Interval of at least 5 minutes between the two different eye drops

Question 5

If an ointment and eye drop are being applied on the same day, what should be used first?

Answer 5

1. Eye drops
2. 5 minutes later (or depending on what the product literature says), ointment

Question 6

What are some things to consider with local eye treatments?

Answer 6

1. Systemic SEs
2. Nasal drainage
3. Blurred vision
4. Contact lens wearers

Question 7

Contact lens wearers

Answer 7

• Some drugs and preservatives can accumulate in hydrogel (soft) contact lenses = toxic and adverse drug reactions
• Remove lenses and avoid wearing for the duration of treatment
• PF can be used
• X eye ointment with lenses !!

Question 8

How long should eye drops be used until disposal?

Answer 8

• If multiple-application containers are for home use, then they should be discarded after 4 weeks of opening (unless stated otherwise)
• Multiple-application containers in the hospital are discarded after 1 week of opening

Question 9

What are eye lotions?
What are the main
uses?

Answer 9

• These are solutions for the irrigation of the conjunctival sac
• They act mechanically to flush out irritants or foreign bodies as a first-aid treatment
• Sterile sodium chloride 0.9% solution is normally used

Question 10

Which systemic drugs can have an adverse effect on contact lenses?

Answer 10

1. Oral contraceptives
   - Particularly those with high estrogen content
2. Drugs which reduce blink rate
3. Drugs which reduce the secretion of tears
4. Drugs which increase tear secretion
5. Isotretinoin - Causes conjunctival inflammation
6. Aspirin - Irritation
7. Rifampicin and Sulfasalazine

Question 11

Rifampicin and Sulfasalazine

Answer 11

Can discolour contact lenses

Question 12

Drugs which reduce blink rate

Answer 12

• Anxiolytics
• Hypnotics
• Antihistamines
• Muscle relaxants

Question 13

Drugs which reduce the secretion of tears

Answer 13

• Antihistamines
• Antimuscarinics

Question 14

Drugs which increase tear secretion

Answer 14

• Ephedrine
• Hydralazine

Question 15

Corticosteroid eye drops

Answer 15

1. betamethasone
2. dexamethasone
3. fluorometholone
4. prednisolone

Question 16

How often are corticosteroids applied?

Answer 16

• Short-term use ONLY
• Frequently for the first 24-48 hours
• Once inflammation is controlled, the frequency of application is reduced e.g.
  QDS, then TDS, then BD, then
  OD

Question 17

What are the THREE main dangers associated with corticosteroid use?

Answer 17

• Red eye
  HSV
• Steroid glaucoma
• Steroid cataract

Question 18

Which formulation of corticosteroids is normally used for macular oedema?

Answer 18

• Intravitreal implants

Question 19

Which NSAIDs are available as eye drops?

Answer 19

1. Diclofenac
2. Flurbiprofen
3. Ketorolac
4. Nepafenac

Question 20

NSAID eye drops - indications

Answer 20

Prophylaxis + treatment of inflammation of the eye following surgery

Question 21

Which drugs are used for seasonal allergic conjunctivitis?

Answer 21

1. Antihistamines
   - Azelastine
   - Epinastine
   - Ketotifen
   - Olopatadine
2. Mast-cell stabilisers
   - Lodoxamide
   - Sodium cromoglicate

Question 22

What is the use of ciclosporin as an eye drop?

Answer 22

• Severe keratitis in dry eye disease that has not responded to treatment with tear substitutes

Question 23

How do you treat uveitis?

Answer 23

1. Antimuscarinic eye drops!
   - Atropine sulfate
   - Cyclopentolate

Question 24

What are the side effects of antimuscarinic eye drops?

Answer 24

• Side-effects of usual anti-muscarinic effects can occur due to systemic absorption
• Conjunctivitis can also occur due to prolonged use

Question 25

Which patients are cautioned on the use of antimuscarinic eye drops?

Answer 25

• < 3 months
• Dark iris (More resistant to pupillary dilation)
• Mydriasis (dilation of the pupil) can precipitate acute-angle colure glaucoma (especially in those over 60)