Opthalamic and Contact Lens Care Flashcards
Risk factors for dry eye disease:
- aging
- lid/corneal defects
- loss of lid tissue
- medications
- some conditions
- allergens/environmental factors
- LASIK
Medications that increase the risk for dry eye disease:
- one that have anticholinergic activity
- antihistamines
- antidepressants
- decongestants
- diuretics
- beta blockers
Conditions that increase the risk for dry eye disease:
- Sjogren syndrome
- Bell’s palsy
- thyroid disorder-related eye disease
- rheumatoid arthritis
Presentation of dry eyes:
- white sclera
- mildly red eye
- sandy, gritty feeling
- initial tearing, then dry
Goals of treatment for dry eyes:
- alleviate dryness of ocular surface
- relieve symptoms of irritation
- prevent possible corneal and non-corneal tissue damage
Nonpharmacologic treatments for dry eyes:
- warm compress
- maintain good eyelid hygiene
- supplements (omega-3 or flaxseed oils)
- avoid dry/dusty environments
Pharmacologic therapies for dry eyes:
- artificial tear solutions
- nonmedicated ointments
Artificial tear solutions:
- provide ocular lubrication
- stabilize tear film
- protect corneal and conjunctival cells
- reduce tear evaporation
- enhance wound healing
Artificial tears contain…
substituted cellulose ethers
Dosage for artificial tears:
instill gtts into eyes QD or BID either in AM or HS
Nonmedicated ointments:
- provide lubrication
- longer retention time in the eye
- enhance tear film integrity
Primary ingredients for nonmedicated ointments:
- white petroleum: lubricates
- mineral oil: melts at body temp
- lanolin: prevents evaporation
Dosing for nonmedicated ointments:
- apply to eyes BID
- can be given every few hours or as needed
- usually at HS to prevent morning dry eye syndrome
Allergic conjunctivitis:
antigens cause ocular irritation
- refer to MD if symptoms don’t resolve w/in 72 hours of treatment
Presentation of allergic conjunctivitis:
- red eye w/ watery discharge
- pruritus (itching)
- excessive tearing (blurry vision)
Goals of treatment for allergic conjunctivitis:
- remove allergen
- limit/reduce severity of reaction
- provide symptomatic relief
- protect ocular surface
Nonpharmacologic treatment for allergic conjunctivitis:
- avoid allergen
- cold compress 3-4 times/day
- monitor pollen count
- keep doors/windows closed
- use a/c and air filters
Pharmacologic treatment for allergic conjunctivitis:
- artificial tears
- antihistamine
- opthalmic decongestants/alpha agonists
Use of artificial tears in allergic conjunctivitis:
washes out allergens and provide symptom relief
Antihistamines in allergic conjunctivitis:
- ketotifen fumarate 0.025%
- use for > 3 YO
- eye itch relief
- relief in few minutes and lasts up to 12 H
Dosing for antihistamines:
instill gtts in eyes BID
- remove contacts before use
- insert contacts after 10 minutes
Adverse effects for antihistamine:
- stinging
- burning
Ophthalmic decongestants/alpha agonists help reduce…
- redness
- vascular congestion
- eyelid edema
Ophthalmic decongestants/alpha agonists for allergic conjunctivitis act as…
local vasoconstrictors
Ophthalmic decongestants/alpha agonists can cause…
rebound conjunctival hyperemia (rebound redness), which is when symptoms get worse after they improve
Dosing for ophthalmic decongestants/alpha agonists:
instill gtts into eyes QID for up to 72 H
- avoid use in acute angle glaucoma
- use with caution with hypertension, ateriosclerosis, diabetes, CVD
Adverse effects of ophthalmic decongestants/alpha agonists:
- stinging
- burning
Ophthalmic antihistamines are used in combination w/…
ophthalmic decongestants
Minor eye irritation is caused by…
- loose foreign substances
- contacts
- wind
- sun
- smog
- etc
Presentation of minor eye irritation:
- redness
- pain
- feeling of sand in the eyes
Pharmacologic treatments for minor eye irritation:
- artificial tears
- non-medicated ointments
- mild astringent drops
Dosing for mild astringent drops:
instill gtts 1-2 drops up to QID
Eye vitamins/supplements:
- can help reduce the risk of age related eye diseases
- vitamin A, C, and E
- zinc
- copper
- lutein
- omega 3 fatty acids
- zeaxanthin
Ocuvite adult 50+ age adjusted formula is made of…
- zinc 9 mg
- vitamin C 150 mg
- vitamin E 30 IU
- copper 1 mg
- lutein 6 mg
- omega 3 150 mg
Dosing for ocuvite adult 50+ age adjusted formula:
1 soft gel PO QAM w/ food
Adverse effects of ocuvite adult 50+ age adjusted formula:
GI upset
PreserVision eye vitamin formula contains:
- zinc: 17.4 mg
- vitamin c: 113 mg
- vitamin E: 100 IU
- omega 3: 250 mg
- lutein: 2.5 mg
- zeaxanthin: 2 mg
Dosing for PreserVision eye vitamin formula:
2 soft gels QD w/ food
- 1 in AM and 1 in HS
Adverse effect of PreserVision eye vitamin formula:
GI upset
Two types of solutions:
- w/ preservatives
- w/out preservatives
Solutions w/ preservatives:
- allow multiple uses out of one bottle
- can cause irritation of ocular surface w/ frequent use
Solutions w/out preservatives:
- discarded immediately after opening and administration
- non-irritating but more expensive
When should solutions be discarded or replaced?
30 days after sterility seal is opened
- expiration date doesn’t apply when opened
Types of lens:
- soft
- rigid, gas permeable
Soft lenses:
- contains water
- most HCP lens of choice
- mass produced, flexible
- has to be replaced daily, every few weeks, or every few months
Rigid, gas permeable lenses:
- custom fit
- uncomfy at first
- replace after several years
Goals of proper lens care:
- remove debris from lens surface
- prevent accumulation of proteins from tear layer
- disinfect lens of organisms
You should leave contact lenses in solution for at least…
6 H
You should thoroughly rinse lenses w/ ______ before inserting
saline
Multipurpose solutions are…
all in one products
Before touching lenses, make sure to…
wash hands w/ soap
When applying solution to lenses, make sure to…
rub lenses between fingers
Before inserting contacts, make sure to…
inspect lenses for chips, tears, and foreign bodies
When cleaning lenses, make sure to…
rub them back and forth, not circular
