Hyperosmotic Agents (M1)

Question 1

What is the mechanism of action of hyperosmotic agents?

Answer 1

increase tonicity of tear film to enhance fluid movement out of cornea across epithelium

Question 2

What are the most common indications of hyperosmotic agents?

Answer 2

1. Fuch’s Endothelial Dystrophy
2. Bullous keratopathy
3. Acute corneal hydrops
4. Prevention of RCE

Question 3

What are the symptoms of Fuch’s Endothelial Dystrophy?

Answer 3

1. blurry vision

2. worse in morning b/c endothelial pumps not working as hard at night

Question 4

What is the mechanism of Bullous Keratopathy? 1. What is it treated with? 2

Answer 4

1. so much stromal edema that have rupture in Bowman’s membrane and fluid rushes into epithelium
2. hyperosmotic and topical NSAID

Question 5

What is the mechanism of corneal hydrops? 1. How is it treated? 2

Answer 5

1. keratoconic patients have rupture in Descemets membrane so rush of fluid into stroma
2. hyperosmotic ointment at all times (because can’t see anyways)

Question 6

How long is the use of hyperosmotic agents in the prevention of recurrent corneal erosions following EBMD usually? 1. What is an alternative to this treatment? 2

Answer 6

1. 3 months

2. PTK surgery