A very concise set of notes covering the important aspects of ocular drugs & diseases required to pass the GPhC exam. Topics include:
- Preservatives
- Contact Lenses
- Conjunctivitis
- Ocular anti-inflammatories
- Ocular Mydriatics
- Glaucoma
TYPES OF OPHTHALMIC PREPS:
1- Eye Drops – preservative and preservative free (PF):
- Preservatives are needed to prevent microbial contamination of drops
- Preservatives are also toxic to sensitive corneal cells irritation & dryness
- If a pt has to administer drops > 4x daily – use PF forms to prevent irritation
- PF forms are typically UNIT DOSE (vials) – but some newer forms are MULTI-DOSE PF
2- Eye Gels & Ointments:
- Typically reserved for more SEVERE dry eye conditions
- Longer onset of action – but also have longer duration (more effective long-term)
- Thickness of these formulations more blurred vision (so typically used at night)
ADMINISTERING OPHTHALMIC PREPS:
- Generally, eye drops, gels & ointments are applied the SAME WAY:
1- Instil drop/gel/ointment in pocket formed in lower eyelid
2- Blink a few times to allow even distribution
3- Close eyes for ~ 30 secs – 1 minute whilst pressing against inner corner of eye
(more absorption into eye & less absorption into nasopharynx systemic abs)
- If using different types of drops together – WAIT 5 MINS between doses (otherwise
the 2nd drop will wash out the 1st drop)
- Eye ointments are always administered AFTER other eye preps
- Typically, only ONE drop of an eye prep is required per dose – using multiple doses at
the same time overflow out of eye waste of product
EYE DROP COMPLIANCE AIDS:
- Compliance aids: devices which help patients administer drops
effectively
- WHO IS THIS AIMED AT:
o Poor manual dexterity (e.g. arthritis, Parkinson’s)
o Impaired vision (e.g. glaucoma, cataracts)
Some are product-specific, some are available on NHS – more info on Moorfields Eye
Hospital website (patient-friendly):
https://www.moorfields.nhs.uk/sites/default/files/Eye%20drop%20compliance%20aids.pdf
CONTACT LENSES, PRESERVATIVES, EXPIRY DATES
OVERVIEW:
- TWO MAIN TYPES:
o Hard (RGP) – individualised to eyeball better visual acuity (but less comfy)
o Soft – one size fits all not as good as hard lenses (but comfier)
- NEVER wear contacts to sleep (unless they’re designed for that purpose)
- Important that pt knows how to change & clean contacts (& how often to do so)
Keratitis (non-infectious & infectious) is the MOST common complication of improper lens use –
other complications include conjunctivitis and dry eyes
, CONTACTS & OPHTHALMIC PREPS:
- Generally, POM & P drops should NOT be used with contacts (soft & hard) – WHY:
o Preservatives accumulate in lens corneal irritation
o Some drops are viscous/oily accumulate in lens discolouration/blurring
- If pt has to use drops that are NOT compatible – instil drop then wait 15 mins
before wearing contacts (or until infection has cleared)
- Only Lubricating & Rewetting drops can be used w/ contacts if they’re PF:
o Lubricating drops: lubricates the eye itself (tend to be more oily)
o Rewetting drops: moistens the contact lens (so lens soaks up less
moisture/tears from the eye less dryness & irritation)
Always check w/ manufacturer if a drop is compatible with contacts e.g. Hylo Forte
NEVER use gels/ointments w/ contacts – too oily
Why Hylo-Tear/Forte is good (but more expensive)
- PF: safe to use whilst wearing contacts
- Maintains sterility for 6 months (not 28 days)
- Uses a similar mechanism to nasal sprays (press down on
plunger) – releasing a single drop at the same velocity per
dose (very accurate)
CONTACTS & SYSTEMIC MEDS:
- Some oral/systemic meds should be used with CAUTION with contacts:
o Sulfasalazine yellow discolouration of contacts
o Rifampicin red-orange discoloration of contacts
o Antihistamines & Antimuscarinics (including TCAs) less lacrimation XS
dryness & irritation
o Aspirin readily excreted into tears corneal irritation
EYE DROP SHELF-LIFE AFTER OPENING: (to maintain sterility)
- If pt has been prescribed multi-dose bottle for HOME or HOSPITAL use:
o Bottle should be discarded FOUR WEEKS after opening (unless otherwise
stated by manufacturer e.g. Hylo-Tear)
- If pt has to be given drops in SPECIALIST SETTING (including in EYE SURGERY):
o Single-use (UD) drops should be used – OR discard the multi-dose bottle after
ONE USE
EYE CONDITIONS (SEE BELOW)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller muammalal-bayati. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £6.48. You're not tied to anything after your purchase.
