opthamalic Flashcards by Aika Bush

Do not self treat eye disorders

-pain
-blurred vision
-light sensitivity
-contact lens
-blunt trauma
-chemical exposure to eye
-eye exposure to heat
-symptoms longer than 72 hours

How well did you know this?

Not at all

Perfectly

Causes of dry eye

-physical abnormalities
-contact lenses
-health conditions: Sjoogren’s syndrome, XXX, RA, thyroid
-Medications: antihistamines, TCAs, diuretics, some XXX
-envirorment

How well did you know this?

Not at all

Perfectly

Symptoms of dry eyes

-normal to XXX
-discomfort
-blurred vision
-discharge from excessive XXX
-urge to rub eyes
-sensation of something in eye

How well did you know this?

Not at all

Perfectly

non pharmacologic dry eyes

-avoid enviormental trigggers
-humidify dry air
-change meds
-cool compress

How well did you know this?

Not at all

Perfectly

OTC treatments dry eyes

-artificial tear
-non medicated ocular gels
-non medicated opthalmic ointment

How well did you know this?

Not at all

Perfectly

Follow up reccomendation dry eyes

-after 1 week: refer severe discomfort
-worsenting condition

How well did you know this?

Not at all

Perfectly

artificial tears MOA

-Prevent/reduce tear evaporation, stabilize tear film
-Facilitate wetting of cornea by increasing XXX
-coat surface of eye, protect underlying cornea cells + conjunctiva
-MOA povidone: forms hydrophilic layer on cornea (like mucin)

How well did you know this?

Not at all

Perfectly

artificial tears dosing

-Initial: BID to once daily
-maintenance: 1-2-3x/daily to hourly

How well did you know this?

Not at all

Perfectly

artificial tears side effects

-rippled surface of cornea
-preservative toxicity
-cellulose ethers: XXX on eye lids
-Dextran 70: temporary stinging
-temporary blurred vision

How well did you know this?

Not at all

Perfectly

artificial tears drug interactions

-PVA may react to cause thickening of solution containing PVA: Reacts with: sodium bicarbonate, sodium borate, sodium/potassium/zinc sulfate

How well did you know this?

Not at all

Perfectly

artificial tears product selection

-balance: number of drops, viscosity, preservatives
- more drops=higher risk of toxicity
-non preserved products: discard unused immediately

How well did you know this?

Not at all

Perfectly

ocular gel and ointment MOA

Occlusive film on eye
surface

How well did you know this?

Not at all

Perfectly

ocular gel ingrediants

same as solution with additional agents to creat gel

How well did you know this?

Not at all

Perfectly

ointment ingrediants

white petroleum, mineral oil, lanolin

How well did you know this?

Not at all

Perfectly

How to manage blurred vison

XXX or use just at bedtime

How well did you know this?

Not at all

Perfectly

symptoms of Allergic Conjunctivitis

-red eye and watery discharge
-ocular XXX
-ocular burning
-blurred vision due to tearing

How well did you know this?

Not at all

Perfectly

no pharma Allergic Conjunctivitis

-cool, moist compress 3-4 times day
-trigger avoidance

How well did you know this?

Not at all

Perfectly

OTC treatment for Allergic Conjunctivitis

-ocular: lubricants, decongestants, antihistamines, decongestant/antihistamines, antihistamines-mast cell stabilizer
-oral antihistamines
-combo eye and oral

How well did you know this?

Not at all

Perfectly

Follow up reccomendations for Allergic Conjunctivitis

-24 hours: tears
-72 hours: everything else

How well did you know this?

Not at all

Perfectly

Ocular decongestants(-ine drugs) MOA

alpha receptor agonism; reduces redness via vasoconstriction
of XXX

How well did you know this?

Not at all

Perfectly

Pharmacodynamics of ocular decongestants/vasoconstrictors

-Duration:
–Phenylephrine: 30 to 90 minutes
–Tetrahydrozoline: 1-4 hours
–Naphazoline: 3-4 hours
–Oxymetazoline: 4-6 hours
–Brimonidine: 6-8 hours

How well did you know this?

Not at all

Perfectly

Ocular decongestants/vasoconstrictors side effects

-rebound congestions
-hyperemia
-allergic conjuctivitis
-pupil dilation
-momentary stinging
-epithelial zerosis

How well did you know this?

Not at all

Perfectly

Ocular decongestants/vasoconstrictors drug interaction

-possible but unlikely: atropine, TCAs, MAOIs, methyldopa

How well did you know this?

Not at all

Perfectly

when to avoid Ocular decongestants/vasoconstrictors

-glaucoma
-hyperthyroidism
-children < 6
-ASCVD, arrhythmias, DM, BPH
Avoid: use longer than 72 hours! (brimonidine: 4 wks)

How well did you know this?

Not at all

Perfectly

Ocular decongestants/vasoconstrictors dosing

-1-2 drops -Tetrahydrozoline: every 4 hr -Others: every 6 hours

Ocular decongestants/vasoconstrictors in pregnancy/lactation

likely ok but check with healthcare provider

Ocular antihistamines/MC stabilizers MOA

-H1 -receptor antagonists: pheniramine -H1 -receptor antagonist/mast cell stabilizer: ketotifen, olopatadine

Ocular antihistamines/MC stabilizers pharmacodynamics

-Pheniramine: 3-4 hours * Ketotifen: 8-12 hours * Olopatadine: depends on dosing: Twice daily with lower concentration: 8 hours or Once daily with higher concentration: 16 hours

Ocular antihistamines/MC stabilizers side effects

momentary stinging/burning, eye redness, pupil dilation

When to avoid Ocular antihistamines/MC stabilizers

not for contact lens irritation, avoid if narrow-angle glaucoma; 72 hour warning for pheniramine combo

Ocular antihistamines/MC stabilizers Dosing

-5 min apart from other eye meds,10 minutes before inserting contact lenses -Pheniramine combo: 1-2 drops 3-4x/day -Ketotifen: 1 drop twice daily (age 3 & older) -Olopatadine: 0.1%: 1 drop twice daily, separated ___ hours, ages 2 & older, 0.2%: 1 drop ONCE daily (ages 2 & older)

Ocular astringents MOA

help dry eye

Ocular astringents

-zinc sulfate and benzalkonium chloride(BAK_ -combination with and decongestant or antihistamine/MC stabilizer

Causes of corneal edema

-prolonged wearing of contacts -surgical damage -hereditary conditions -glaucoma -iritis -infection

corneal edema symptoms

-blurred/foggy vision -light halos/starbursts -blisters which may rupture

OTC treatments corneal edema

-sodium chloride: 2% soln., 5% soln., 5% oint

corneal edema follow up recomendations

-1 week

corneal edema treatment algorithm

-1st line: 2% soln 4x/day -2nd line: add 5% oint at night -3rd line: switch to 5% soln 4x/day and continue ointment

Sodium chloride 2%, 5% MOA

increase tonicity of tear film which moves water from cornea to tears --> removed by tear flow

Sodium chloride 2%, 5% side effects

momentary burning, eye irritation, eye redness, vision changes (all = more common with ____)

Sodium chloride 2%, 5% dosing

-1-2 drops every 3/4 hours -ointment: thin ribbon at bedtime

Sodium chloride 2%, 5% in pregnancy/lactation

check with healthcare provider

Removal of foreign object in eye

-blink/tear -flush with water

Avoid with Ophthalmic irritants

open wounds in/near eyes, eye pain, vision changes, ongoing redness/irritation, EYE CUPS

how to use ocular irritant solution

1)wash hands 2)head over sink with head tilted 3)hold eyelids apart and flush with solution 4) discard remaining solution and bottle

non pharma Minor eye irritation

-cool, moist compress

Minor eye irritation OTC treatment

-artificial tears/ointments -zinc sulfate soln

Minor eye irritation follow up recomendation

72 hours

Zinc sulfate ophthalmic solution MOA

astringent; shrinks mildly inflamed tissues; dries excess secretions

Zinc sulfate ophthalmic solution side effects

eye irritation, reddness

Zinc sulfate ophthalmic solution dosing

1-2 drops 4x/day

Avoid Zinc sulfate ophthalmic solution in...

children younger than XXX

causes of Blepharitis

S. epi, S. aureus, seborrheic dermatitis

Blepharitis symptoms

-pruritis -burning -eyelids: red, scaly, thickened, loss of eyelashes

non-pharma Blepharitis

-hot compress 15-20 min BID to QID

OTC treatments for Blepharitis

-lid scrubs: baby shampoo, eye scrub soln, lid wipes, ocu soft soln.

Hordeolum (Stye) symptoms

-nodule -tender, palpable -eyelid swelling

Hordeolum (Stye) referral

> 1 week or chronic

Hordeolum (Stye) non pharma treatment

-hot compress 3-4 times day for 5-10 min -gentle pressure

Hordeolum (Stye) pharmacologic treatment

-internal: oral antibiotic after 1 week of compresses -external: topical antibiotic if not cleared after 1 week of compresses -surgery