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

act on the ciliary body musculature to inhibit accommodation.

Mydriatic agent


• Synthetic sympathomimetic amine primarily used as a mydriatic

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


• 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


• 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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