Chapter 15 Treatment of Diseases of the Eye

Angle-closure glaucoma

Sudden increase in intraocular pressure due to drainage obstruction, rapidly progressing to blindness.

Aqueous humor

Fluid made in the front part of the eye.

Blepharitis

Chronic disease producing distinctive flaky scales on the eyelids and eyelashes.

Conjunctivitis (pink eye)

Common, self-limiting ailment causing itching, burning, and teary outflow.

Cytomegalovirus retinitis

Viral opportunistic infection of the eye causing pain and blindness.

Dry eye disease

Occurs when tears are insufficient, of incorrect consistency, or evaporate too quickly.

Herpes simplex keratitis

Painful eye infection caused by herpes simplex virus; can lead to blindness.

Herpes zoster ophthalmicus

Painful eye infection caused by herpes zoster virus; can lead to blindness.

Intraocular pressure

Inner pressure of the eye, normally ranging from 12 to 22 mm Hg.

Iritis

Condition associated with inflammation of the iris.

Keratitis

Severe infection of the cornea caused by bacteria or fungi.

Open-angle glaucoma

Gradual increase of eye pressure damaging the optic nerve, leading to permanent blindness.

Peripheral vision

Side vision; usually the first area of vision lost with glaucoma.

Photopsia

Condition similar to floaters, associated with flashes of light.

Stye

Painful eyelid margin lump from acute infection of eyelid oil glands.

Uveitis

Serious inflammation of the uvea, causing scarring and blindness if untreated.

Vitreous floaters

Particles casting shadows on the retina, appearing as spots, cobwebs, or spiders.

Cyclosporine (Ophthalmic) — US Brand Names

Cequa, Restasis, and Verkazia

Cyclosporine (Ophthalmic) — Strengths by Brand

0.05% (Restasis), 0.09% (Cequa), and 0.1% (Verkazia)

Lifitegrast — Brand Name and Strength

Xiidra (5% ophthalmic solution)

Dry Eye Disease — Prescription Ophthalmic Eye Drops

Cyclosporine (Cequa, Restasis, Verkazia) and lifitegrast (Xiidra)

Gentamicin (Ophthalmic) — US Brand and Strength

Genoptic (0.3% solution)

Tobramycin (Ophthalmic) — Brand and Strengths

Tobrex (0.3% ointment and solution)

Neomycin + Polymyxin B + Gramicidin — US Brand

Neosporin (ophthalmic solution)

Polymyxin B + Gramicidin — Canadian Brand

Optimyxin Ophthalmic/Otic

Sulfacetamide Sodium — US Brand and Strength

Bleph-10 (10% ointment and solution)

Trimethoprim + Polymyxin B — Brand Name

Polytrim (ophthalmic solution)

Besifloxacin — Brand and Strength

Besivance (0.6% ophthalmic suspension)

Ciprofloxacin (Ophthalmic) — Brand and Strength

Ciloxan (0.3% ointment and solution)

Gatifloxacin — Brand Names and Strengths

Zymar (0.3% solution), Zymaxid (0.5% solution)

Levofloxacin (Ophthalmic) — Strength and Form

0.5% solution (available as generic)

Moxifloxacin — Brand Names and Strength

Moxeza, Vigamox (0.5% solution)

Ofloxacin — Brand Name and Strength

Ocuflox (0.3% solution)

Azithromycin (Ophthalmic) — Brand and Strength

AzaSite (1% solution)

Erythromycin (Ophthalmic) — Strength and Form

0.5% ointment (available as generic)

Neomycin + Dexamethasone + Polymyxin — Brand Name

Maxitrol (ophthalmic suspension and ointment)

Gentamicin + Prednisolone — Brand Name

Pred-G (ophthalmic suspension and ointment)

Sulfacetamide + Prednisolone — Brand Name

Blephamide (ophthalmic ointment and solution)

Tobramycin + Dexamethasone — Brand Names

Tobradex, Tobradex ST

Tobramycin + Loteprednol — Brand Name and Strengths

Zylet (0.3% tobramycin + 0.5% loteprednol suspension)

Natamycin (Ophthalmic) — US Brand and Strength

Natacyn (5% ophthalmic suspension)

Cidofovir — US Brand and Strength

Generics (75 mg/mL solution for injection)

Foscarnet

Foscavir

Ganciclovir — Brand Names and Strengths

Ganzyk-RTU (2 mg/mL IV solution), Zirgan (0.15% ophthalmic gel), Cytovene (500 mg powder for injection)

Trifluridine — US Brand and Strength

Viroptic (1% ophthalmic solution)

Valganciclovir — Brand Name and Strengths

Valcyte (50 mg/mL oral solution, 450 mg tablet)

Gentamicin 0.3% ophthalmic solution — Usual Dosage

Instill 1-2 drops every 4 hours while awake until resolved.

Gentamicin 0.3% ophthalmic ointment — Usual Dosage

Apply ½-inch ribbon 2-3 times a day to eyelid margin.

Tobramycin 0.3% ophthalmic solution (Tobrex) — Usual Dosage

Instill 1-2 drops in eye(s) every 4 hours.

Neosporin Ophthalmic solution — Usual Dosage

Instill 1-2 drops every 4 hours (up to 2 drops hourly if severe).

Bleph-10 (sulfacetamide) solution — Usual Dosage

Instill 1-2 drops every 1 hour while awake until resolved.

Polytrim (trimethoprim + polymyxin B) — Usual Dosage

Instill 1 drop every 3 hours up to 6 doses/day for 7-10 days.

Besivance (besifloxacin) — Usual Dosage

Instill 1 drop in affected eye(s) 3 times daily for 7 days.

Ciloxan (ciprofloxacin 0.3%) solution — Usual Dosage

1-2 drops every 2 hours (days 1-2), then every 4 hours (days 3-7).

AzaSite (azithromycin) — Usual Dosage

1 drop twice daily (days 1-2), then 1 drop daily (days 3-7).

Erythromycin ophthalmic ointment — Usual Dosage

Apply ½-inch ribbon 2-6 times a day until resolved.

Maxitrol suspension — Usual Dosage

Instill 1-2 drops into eye(s) every 4-6 hours.

Tobradex suspension — Usual Dosage

Instill 1-2 drops in eye(s) every 4-6 hours.

Viroptic (trifluridine) — Usual Dosage

1 drop every 2 hours while awake up to 9 drops/day until healed.

Natacyn (natamycin) for Keratitis — Usual Dosage

1 drop every 1-2 hours for 3-4 days, then every 3-4 hours.

Betaxolol (Ophthalmic) — Brand Names and Strengths

Betoptic (0.5% solution) and Betoptic S (0.25% suspension)

Carteolol (Ophthalmic) — Strength and Form

1% ophthalmic solution (available as generic)

Levobunolol — Brand and Strength

Betagan (0.5% ophthalmic solution)

Timolol Hemihydrate — Brand and Strengths

Betimol (0.25% and 0.5% ophthalmic solution)

Timolol Maleate (Ophthalmic) — US Brand Names

Istalol, Timoptic, Timoptic in OcuDose, and Timoptic XE

Timolol Maleate — Dosage Forms and Strengths

0.25% and 0.5% solution, gel-forming solution, and preservative-free solution

Timolol + Brimonidine — Brand and Strength

Combigan (0.2% brimonidine + 0.5% timolol solution)

Apraclonidine — Brand and Strengths

Iopidine (0.5% and 1% ophthalmic solution)

Brimonidine (Ophthalmic) — US Brand Names

Alphagan P, Lumify, Mirvaso, and Qoliana

Brimonidine — Dosage Forms and Strengths

0.33% gel; 0.025%, 0.1%, 0.15%, and 0.2% ophthalmic solutions

Acetazolamide — Dosage Forms and Strengths

500 mg SR capsule, 500 mg IV powder, 125 mg and 250 mg tablets

Brinzolamide — Brand and Strength

Azopt (1% ophthalmic suspension)

Dorzolamide — Brand and Strength

Trusopt (2% ophthalmic solution)

Methazolamide — Form and Strengths

Tablets: 25 mg and 50 mg (available as generic)

Brinzolamide + Brimonidine — Brand and Strength

Simbrinza (0.2% brimonidine + 1% brinzolamide solution)

Brinzolamide + Timolol — Canadian Brand and Strength

Azarga (1% brinzolamide + 0.5% timolol suspension)

Dorzolamide + Timolol — Brand and Strengths

Cosopt and Cosopt PF (2% dorzolamide and 0.5% timolol solution)

Ending "-zolamide"

Carbonic anhydrase inhibitors

Carbachol — Brand Name and Strength

Miostat (0.01% ophthalmic solution)

Pilocarpine — Brand Names and Strengths

Isopto Carpine (1%, 2%, 4% ophthalmic solution) and Vuity (1.25% ophthalmic solution)

Echothiophate Iodide — Brand Name and Strength

Phospholine Iodide (0.125% powder for reconstitution)

Bimatoprost — Brand Names and Dosage Forms

Durysta (10 mcg implant), Latisse (0.03% topical solution), and Lumigan (0.01%, 0.03% ophthalmic solution)

Latanoprostene Bunod — Brand Name and Strength

Vyzulta (0.024% ophthalmic solution)

Latanoprost — Brand Names and Strengths

Xalatan (0.005% ophthalmic solution) and Xelpros (0.005% ophthalmic emulsion)

Tafluprost — Brand Name and Strength

Zioptan (0.0015% ophthalmic solution)

Travoprost — Brand Name and Strengths

Travatan Z (0.004% ophthalmic solution; 0.003% as Izba in Canada)

Latanoprost + Netarsudil — Brand Name and Strength

Rocklatan (0.005% latanoprost + 0.02% netarsudil ophthalmic solution)

Ending "-prost"

Prostaglandin analogs

Netarsudil — Brand Name and Strength

Rhopressa (0.02% ophthalmic solution)

Netarsudil — Drug Class

Rho Kinase Inhibitor

Betaxolol (Betoptic-S) — Usual Dosage & Warning

Instill 1 drop twice daily; SHAKE WELL (suspension).

Timolol Maleate (Timoptic vs Timoptic XE) — Usual Dosage

Timoptic: 1 drop twice daily. Timoptic XE: 1 drop daily in the morning.

Acetazolamide (Diamox) — Usual Dosage & Warnings

SR: 500 mg twice daily; IR: 250 mg 1-4 times daily. Take with food.

Dorzolamide (Trusopt) — Usual Dosage

Instill 1 drop 3 times a day.

Carbachol (Miostat) — Special Warning

Do not wear contact lenses during use.

Echothiophate (Phospholine Iodide) — Storage Warning

Refrigerate or store reconstituted solution for up to 4 weeks at room temperature.

Bimatoprost, Latanoprost, and Travoprost — Usual Dosage

Instill 1 drop once daily in the evening.

Netarsudil (Rhopressa) — Storage & Discard Warning

Refrigerate unopened; store opened at room temperature; discard 6 weeks after opening.

Apraclonidine (Iopidine) — Usual Dosage

Instill 1-2 drops in affected eye(s) 3 times a day.

Brimonidine (Alphagan) — Usual Dosage

Instill 1 drop in affected eye(s) 3 times a day.