eye and ear conditions (besides glaucoma)

what can cause conjunctivitis?

• virus

• bacteria

• allergen

• ocular irritant

how do you prevent spread of conjunctivitis?

• avoid touching eyes

• use proper hand hygiene — wash hands thoroughly and frequently

• change towels and washcloths daily

• discard eye cosmetics

most common viral cause of conjunctivitis

adenovirus

how do you treat viral conjunctivitis?

let it run it’s course

bacterial causes of conjunctivitis

• staph aureus — common

more severe

• neisseria gonorrhoeae

• chlamydia

topical abx eye drops/ointments for bacterial conjunctivitis

• moxifloxacin (Vigamox)

• neomycin/polymyxin B/dexamethasone (Maxitrol)

• ofloxacin (Ocuflox)

• trimethoprim/polymyxin B (Polytrim)

moxifloxacin

Vigamox

neomycin/polymyxin B/dexamethasone

Maxitrol

ofloxacin

Ocuflox

trimethoprim/polymyxin B

Polytrim

how is azithromycin (AzaSite) eye stored?

refrigerator

stable for 14 days at room temp

tx options for allergic conjunctivitis

• mast cell stabilizers

• antihistamines

• antihistamine/mast cell stabilizers

antihistamines used for allergic conjunctivitis

• azelastine

• olopatadine (Pataday)

antihistamine/mast cell stabilizer for allergic conjunctivitis

ketotifen (Alaway, Zaditor)

blepharitis

eyelid inflammation

primary sx of blepharitis

eyelids:

• inflamed

• irritated

• itchy

preferred tx of blepharitis

application of warm compress over eye for a few minutes to loosen crust, then

use warm, moist washcloth + drops of baby shampoo to wipe away debris

tx for inflammation of eye: mild

NSAID eye dropt

tx for inflammation of eye: severe

steroid eye drop

why do eye drops burn?

preservatives — benzalkonium chloride

what should a person that wears contacts be instructed to do with eye drops?

remove lenses before

wait 15 mins after admin before reinserting

steroid eye drops — for inflammation (severe)

• prednisolone (Pred Forte, Pred Mild)

• dexamethasone (Maxidex, Ozurdex)

• fluorometholone

• loteprednol

NSAID eye drops — for inflammation (mild)

• ketorolac (Acular)

• nepafenac

• bromfenac

• diclofenac

• flurbiprofen

prednisolone eye drop

Pred Forte

Pred Mild

ketorolac eye drop

Acular

why should steroid eye drops only be used for a short period of time?

risk of incr. IOP

tx for eye dryness

artificial tears

• Refresh

  • Systane

tx for chronic dry eye disease

cyclosporine emulsion eye drops (Restasis)

tx for eye redness

• naphazoline (Clear Eyes Redness Relief)

• naphazoline/pheniramine (Naphcon A, Visine A)

• tetrahydrozoline (Visine)

• brimonidine (Lumify)

naphazoline

Clear Eyes Redness Reliefnaphazo

naphazoline/pheniramine

Naphcon A

Visine A

tetrahydrozoline

Visine

drugs that can cause retinal changes/retinopathy

• chloroquine

• hydroxychloroquine

drugs that can cause optic neuropathy

• amiodarone

• ethambutol

• linezolid

drugs that can cause intraoperative floppy iris syndrome: difficulty in cataract surgery

alpha-blockers (tamsulosin)

drugs that can cause changes in color discrimination

digoxin (toxicity) — green/yellow

PDE-5 inhibitors — greenish tinge around objects

voriconazole

drugs that can cause abnormal vision/loss

digoxin (toxicity) — halos, blurriness

PDE-5 inhibitors — vision loss

isotretinoin — decr. night vision, dryness, irritation

topiramate — visual field defects

vigabatrin — permanent vision loss

voriconazole — abnormal vision, photophobia

ear wax

cerumen

tinnitus

ringing in ears

what can salicylate toxicity cause?

tinnitus

tx of ear wax (cerumen) blockage

removed in medical office

cerumenolytics

cerumenolytics

• water

• saline solution

• mineral oil

• hydrogen peroxide

• carbamide peroxide (Debrox)

otitis externa

swimmer’s ear

• inflammation in outer part of ear

  • commonly caused by bacterial infection

mild otitis externa tx

ear drops containing:

• acetic acid +

• glucocorticoid

VoSol HC

moderate to severe otitis externa tx

otic abx

• ciprofloxacin/dexamethasone (Ciprodex)

• ciprofloxacin/hydrocortisone (Cipro HC)

• neomycin/colistin/hydrocortisone/thonzonium (Cortisporin-TC)

eye drops

how long do you need to wait between drops of same drug?

5 mins

eye drops

how long do you need to wait between drops of different drug?

5-10 mins

eye drops

how long do you need to wait to apply gels after using eye drops?

10 mins

eye drops

how long do you need to wait to put contacts back in?

15 mins