4 Common eye medications



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4 Common eye medications

The clinician should have an understanding of all the commonly used ocular med-

ications. In prescribing eye medications or in seeing patients that are on ocular medica-

tions, a knowledge of the mechanisms of action and potential side effects may be valu-

able. It is well known that certain eye medications have been associated with systemic

problems that include myocardial infarction, CNS symptoms, and kidney stones. In ad-

dition, specific eye medications can result in ocular complications that include glau-

coma, cataracts, ptosis, and keratitis.



MYDRIATIC AND CYCLOPLEGIC AGENTS

Mydriatic drugs dilate the pupil. Cycloplegic agents, in addition to dilating the pupil,

act on the ciliary body musculature to inhibit accommodation.

Mydriatic agent

Phenylephrine

• Synthetic sympathomimetic amine primarily used as a mydriatic

• Strength: 0.12, 0.125, 0.2, 2.5, and 10%

Actions

• Mydriasis—produced by stimulation of alpha receptors in the iris dilator muscle; al-

pha stimulation is overcome by bright light that stimulates a parasympathetic re-

sponse and results in pupillary constriction

• Decrease ptosis—useful in mild ptosis secondary to Homer's syndrome; the drug stim-

ulates Miiller's muscle of the lid and results in a decrease in ptosis



Side effects

Systemic


• Hypertension

• Myocardial infarction

Fifteen cases of acute myocardial infarction were documented (Fraunfelder, 1978) after

10% phenylephrine was instilled. Therefore this drug should be used with great caution

in patients with cardiac disease or vascular-occlusive problems.

(maximum effect (maximum

in minutes) effect in hours) Full recovery Table 4.1

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Taken from: Stein, H., Slatt, B., and Stein,

R. (1992) A primer in ophthalmology: A



textbook for students. St. Louis, MO: Mosby

Year Book.


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