EYES (NEW) Flashcards
How are eye drops administered?
- Into the pocket of the eye, by pulling down the eyelid
- Keep the eye closed as long as possible after administration
How is eye ointment administered?
- 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
How to administer local injection into the eye?
- Usually used when higher drug concentrations are required
- Subconjunctival injection
- Intracameral route
- Intravitreal route
If two different eye drops are being used on the same day, can they be used at the same time?
- 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
If an ointment and eye drop are being applied on the same day, what should be used first?
- Eye drops
- 5 minutes later (or depending on what the product literature says), ointment
What are some things to consider with local eye treatments?
- Systemic SEs
- Nasal drainage
- Blurred vision
- Contact lens wearers
Contact lens wearers
- 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 !!
How long should eye drops be used until disposal?
- 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
What are eye lotions?
What are the main
uses?
- 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
Which systemic drugs can have an adverse effect on contact lenses?
- Oral contraceptives
- Particularly those with high estrogen content - Drugs which reduce blink rate
- Drugs which reduce the secretion of tears
- Drugs which increase tear secretion
- Isotretinoin - Causes conjunctival inflammation
- Aspirin - Irritation
- Rifampicin and Sulfasalazine
Rifampicin and Sulfasalazine
Can discolour contact lenses
Drugs which reduce blink rate
- Anxiolytics
- Hypnotics
- Antihistamines
- Muscle relaxants
Drugs which reduce the secretion of tears
- Antihistamines
- Antimuscarinics
Drugs which increase tear secretion
- Ephedrine
- Hydralazine
Corticosteroid eye drops
- betamethasone
- dexamethasone
- fluorometholone
- prednisolone
How often are corticosteroids applied?
- 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
What are the THREE main dangers associated with corticosteroid use?
- Red eye
HSV - Steroid glaucoma
- Steroid cataract
Which formulation of corticosteroids is normally used for macular oedema?
- Intravitreal implants
Which NSAIDs are available as eye drops?
- Diclofenac
- Flurbiprofen
- Ketorolac
- Nepafenac
NSAID eye drops - indications
Prophylaxis + treatment of inflammation of the eye following surgery
Which drugs are used for seasonal allergic conjunctivitis?
- Antihistamines
- Azelastine
- Epinastine
- Ketotifen
- Olopatadine - Mast-cell stabilisers
- Lodoxamide
- Sodium cromoglicate
What is the use of ciclosporin as an eye drop?
- Severe keratitis in dry eye disease that has not responded to treatment with tear substitutes
How do you treat uveitis?
- Antimuscarinic eye drops!
- Atropine sulfate
- Cyclopentolate
What are the side effects of antimuscarinic eye drops?
- Side-effects of usual anti-muscarinic effects can occur due to systemic absorption
- Conjunctivitis can also occur due to prolonged use
Which patients are cautioned on the use of antimuscarinic eye drops?
- < 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)
