Term
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Definition
| a group of eye disorders that damage the optic nerve |
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Term
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Definition
Glaucoma that occurs as a result of a narrowed anatomic angle between the lens and cornea
Also called: closed-angled glaucoma, narrow-angled glaucoma, and pupillary glaucoma |
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Term
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Definition
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Term
| Sympathomimetic Drugs are |
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Definition
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Term
| Acetylcholine Indications |
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Definition
| For complete and rapid miosis after cataract lens extraction, iridectomy |
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Term
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Definition
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Term
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Definition
(Cholinergic)
Accommodative esotropia, obstructive aqueous humor outflow, open-angled glaucoma after iridectomy |
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Term
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Definition
(Cholinergic)
Open-angled glaucoma
Secondary glaucoma after iridectomy
reversal of cycloplegia |
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Term
| Contraindication of Cholinergic Drugs |
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Definition
Serious active eye disorder
Acetylcholine, Carbachol, echothiophate, Pilocarpine |
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Term
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Definition
Direct-acting cholinergic
Produce miosis during ophthalmic surgery
very quick onset |
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Term
| Acetylcholine Administered |
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Definition
| directly into the anterior chamber of the eye before and after securing one or more sutures |
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Term
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Definition
direct-acting cholinergic
treatment of glaucoma
Pilocarpine ocular insert system (Ocusert Pilo-20), which is applied once weekly by the patient |
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Term
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Definition
Indirect cholinergic
Cholinesterase inhibitor
Effect is normally irreversible until new enzymes are synthesized by the body
Can take days to weeks, for this reason it is consider long-acting |
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Term
Epinephrine and Dipivefrin
Indication |
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Definition
reduce elevated intraocular pressure in the treatment of
Chronic open-angled glaucoma short or long term
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Term
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Definition
(alpha2 and beta2)
corrects surgery-induced elevation in intraocular pressure |
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Term
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Definition
(alpha2)
Used to lower intraocular pressure in patients with open-angled glaucoma or ocular hypertension |
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Term
Sympathomimetic Drugs
Interactions |
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Definition
Cause cardiac dysrhythmias when given with
halogenated anesthetics, cardiac glycosides, thyroid hormones, or tricyclic antidepressants |
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Term
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Definition
(Prodrug of Epinephrine)
It has enhanced lipophilicity (fat soluble) and can better penetrate into the tissue of the anterior chamber of the eye.
4 to 11 time more potent than Epinephrine in reducing pressure
5 to 12 more potent in terms of mydriatic effect |
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Term
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Definition
Reduce intraocular pressure by reducing aqueous humor formation.
Timolol may produce a minimal increase in aqueous outflow |
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Term
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Definition
| reduces intraocular pressure by enhancing aqueous humor outflow through the canal of Schlemn |
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Term
Beta-Adrenergic blocker
Indication |
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Definition
chronic open-angled glaucoma
ocular hypertension |
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Term
Beta-Adrenergic blocker
Adverse Effects |
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Definition
Limited to site of action
photophobia, lacrimation, blepharitis, ect |
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Term
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Definition
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Term
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Definition
non-selective beta blocker
May increase outflow of aqueous humor as well as decrease its formation
Come in gel-form for long-acting once a day dosing |
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Term
Carbonic Anhydrase Inhibitors
MOA |
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Definition
Inhibits the enzyme carbonic anhydrase
Which results in decreased intraocular pressure by reducing aqueous humor formation
Dorzolamide |
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Term
Carbonic Anhydrase Inhibitor
Indication |
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Definition
open and closed-angled glaucoma
preoperatively to control intraocular pressure
Dorzolamide |
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Term
Carbonic Anhydrase Inhibitor
Contraindications |
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Definition
Sulfa Allergies
Dorzolamide |
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Term
Carbonic Anhydrase Inhibitor
Adverse Effects |
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Definition
| Can be absorbed systemically |
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Term
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Definition
Carbonic Anhydrase Inhibitor
Treat ocular hypertension or open-angled glaucoma |
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Term
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Definition
reduce ocular hypertension by causing the blood to become hypertonic in relation to both intraocular and spinal fluid, which draws water from the aqueous and vitreous humors into the bloodstream, which causes a reduction in the volume of intraocular fluids
Glycerin, Mannitol, Urea, and Isosorbide |
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Term
Osmotic Diuretics
Indication |
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Definition
Acute glaucoma episodes
reduce intraocular pressure before or after ocular surgery
Glycerin is used first, and if unsuccessful, use Mannitol
Isosorbide and Urea used if both unsuccessful |
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Term
Osmotic Diuretics
Contraindication |
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Definition
Pronounced anuria, acute pulmonary edema, cardiac decompensation, and severe dysrhythmia
glycerin, mannitol, urea, isosorbide |
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Term
Osmotic Diuretics
Adverse Effects |
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Definition
Nausea, vomiting, headache, and fluid and electrolyte imbalance
Mannitol and Urea can increase Lithium excretion
Glycerin, mannitol, urea, isosorbide |
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Term
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Definition
Osmotic Diuretic
Reserved for Acute reduction of intraocular pressure during glaucoma crisis |
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Term
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Definition
Osmotic Diuretic
Intravenous Infusion; reduce intraocular pressure when the pressure cannot be lowered by other methods
Does not penetrate the eye, like urea |
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Term
Prostaglandin Agonist
MOA |
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Definition
Reduce intraocular pressure by increasing the outflow of aqueous humor between the uvea and sclera as well as via the usual exit through the trabecular meshwork
Latanoprost, Travoprost, and Bimatoprost |
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Term
Prostaglandin Agonist
Suffix |
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Definition
-prost
Latanoprost, Travoprost, and Bimatoprost |
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Term
Prostaglandin Agonist
Indication |
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Definition
treat glaucoma
Latanoprost, Travoprost, and Bimatoprost |
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Term
Prostaglandin Agonist
dosing |
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Definition
Single dose lowers intraocular pressure for 20 to 24 hours, which allows for single daily dosing
Latanoprost, Travoprost, and Bimatoprost |
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Term
Prostaglandin Agonist
Adverse Effects |
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Definition
People with hazel, green, or bluish-brown eye color will turn permanently brown, even if the medication is discontinued
Latanoprost, Travoprost, and Bimatoprost |
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Term
Prostaglandin Agonist
Interaction |
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Definition
Eye drops containing Thimerosal may result in precipitation
Administer at least 5 minutes apart
Latanoprost, Travoprost, and Bimatoprost |
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Term
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Definition
When administered it is converted to prostaglandin F2-alpha by the water from the ocular fluids
Increases iris pigmentation after 3 to 4 1/2 months of treatment in 3% to 10% of patients |
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Term
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Definition
Gentamicin
Treat resistant staphylococci and streptococci
Adverse Effects: swollen eyelids, mydriasis, and local erythema
Also tobramycin |
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Term
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Definition
Erythromycin
Treat neonatal conjunctivitis and prevent eye infection in newborns |
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Term
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Definition
Bacitracin
Treat superficial infections caused by gram-positive bacteria
Polymyxin B also used |
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Term
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Definition
Ciprofloxacin
A/E appearance of white, crystalline precipitates occurring within any corneal lesion
Happens within 1 to 7 days
Therapy is not discontinued
Others used: gatifloxacin, Moxifloxacin, levofloxacin, and ofloxacin |
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Term
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Definition
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Term
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Definition
Sulfacetamide
Treat conjunctivitis |
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Term
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Definition
Natamycin
Treats Blepharitis, conjunctivitis, and keratitis caused by Candida and Aspergillus |
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Term
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Definition
Trifluridine
Treats keratitis and keratoconjunctivitis caused by type 1 and 2 herpes simplex virus
Inhibits viral replication by blocking synthesis of DNA |
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Term
| What should the nurse expect to use to treat neonatal conjunctivitis? |
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Definition
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Term
| What is a common adverse effect of Ciprofloxacin and what should you do? |
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Definition
Appearance of white, crystalline precipitates occurring within any corneal lesion
Continue therapy
Another is cornea staining |
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Term
A patient has keratoconjunctivitis that was caused by type 2 herpes simplex virus. What drug will the nurse expect to administer?
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Definition
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Term
Anti-inflammatory Drugs
Indication |
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Definition
NSAID or Corticosteroid
Treat corneal, conjunctival, and scleral penetration of foreign bodies. Inflammatory disorders or surgery related pain
Prevent fibrosis and scarring
NSAIDS are for initial topical therapy
Dexamethasone, Flurbiprofen, and Ketorolac
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Term
Anti-inflammatory Drugs
Contraindication |
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Definition
Not used for minor abrasions or wounds because they suppress the immune system
Dexamethasone, Flurbiprofen, and Ketorolac |
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Term
Anti-inflammatory Drugs
Adverse effects |
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Definition
Extended use of Corticoids may result in cataracts, increased intraocular pressure, and optic nerve damage
Dexamethasone, Flurbiprofen, and Ketorolac |
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Term
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Definition
Corticosteroid
treatment of inflammation of the eye, eyelids, conjunctiva, and cornea
treatment of uveitis, iridocyclitis, allergic conditions, and burns and in the removal of foreign bodies |
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Term
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Definition
NSAID
Treat inflammatory ophthalmic conditions
Postoperative inflammation after a cataract extraction |
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Term
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Definition
NSAID
Oral or injectable for systemic use
reducing ocular inflammation
This drug will delay eye wound healing and lead to corneal epithelial breakdown |
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Term
| Tetracaine and Proparacaine |
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Definition
Topical Anesthetics
Eye drops to numb the eye for various short ophthalmic procedures
works in 25 seconds and lasts 15 to 20 minutes
Apply as needed
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Term
Atropine Sulfate
(Cycloplegic Mydriatic) |
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Definition
Causes Mydriasis
Paralyzes the ciliary muscle and prevents accommodation
Treats uveal tract inflammatory states
1 to 2 drops or 0.3 to 0.5 cm of ointment, 2 to 3 times a day |
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Term
Cyclopentolate
(Cycloplegic Mydriatic)
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Definition
Used for diagnostic purposes only and not treatment of inflammatory states
dosage is 1 to 2 drops and repeated in 5 to 10 minutes if needed
subsides within 24 hours |
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Term
| What would you use to numb the eye during mydriatic or cycloplegic diagnostics? |
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Definition
| Cyclopentolate or Tropicamide |
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Term
Ophthalmic Dye
Name and Administration |
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Definition
Fluorescein (Fluoresc as in Fluorescent)
Used to identify corneal defects and foreign objects
After instillation, various defects are highlighted in either bright green or yellow-orange, and foreign objects have a green halo around them |
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Term
| What would you use to identify corneal defects? |
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Definition
| Fluorescein, an ophthalmic dye |
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Term
| What eyedrop would you use for allergic conjunctivitis? |
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Definition
Olopatadine an antihistamine
or Azelastine, emedastine, ketotifen, and Epinastine |
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Term
| What drug would you use for treatment of Vernal Keratoconjunctivitis(Springtime inflammation of the cornea and conjunctiva)? |
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Definition
Cromolyn
(Mast Cell Stabilizer)
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Term
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Definition
Ocular Decongestant
Vasoconstrictors blood vessels in and around the eye
reduce edema, controls redness, burning, and other minor irritations |
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Term
| What would you use to control redness and burning related to allergies? |
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Definition
Tetrahydrozoline
(Decongestant) |
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Term
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Definition
ophthalmic form of cyclosporine(immunosuppressant)
Promotes tear production
Can use with artificial tears, given 15 minutes apart |
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Term
| What would you take to promote tear production? |
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Definition
| Restasis (immunosuppressant) |
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Term
| How far apart should artificial tears and Restasis be administered? |
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Definition
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Term
| Parasympathomimetic ophthalmic drugs such as pilocarpine (Pilocar) reduce intraocular pressure in the treatment of glaucoma by which mechanism of action? |
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Definition
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Term
Which statement, made by a patient, indicates the need for further patient teaching regarding proper administration of eyedrops?
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Definition
| C. “I will rinse the eyedropper with tap water after each use.” |
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Term
The nurse is providing education to a patient who was diagnosed with bilateral conjunctivitis (pink eye). The patient is prescribed sulfacetamide (Bleph-10) for the diagnosis. What information in the patient history has the highest priority and should be reported immediately to the health care provider?
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Definition
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Term
The nurse is educating a patient who was administered atropine sulfate solution for an eye exam. The nurse includes which information in the education?
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Definition
| Use of sunglasses is encouraged to decrease sunlight sensitivity. |
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Term
The patient has been prescribed an ocular antihistamine, olopatadine (Patanol), for treatment of allergic conjunctivitis. The nurse knows the medication works though which action?
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Definition
| Competing at histamine receptor sites |
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Term
A child born with increased intraocular pressure is likely to be diagnosed with which type of glaucoma?
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Definition
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Term
A patient is prescribed epinephrine eye drops for treatment of chronic open-angle glaucoma. The patient complains of burning with instillation of the drops. How would the nurse respond to the patient?
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Definition
| “This is a typical adverse effect and may lessen over time. If this continues, we need to schedule an appointment with your provider.” |
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Term
Sympathomimetic mydriatics have the potential to react with other drugs if sufficient topical absorption occurs. When given concurrently, drugs in which class may interact with the sympathomimetic mydriatics?
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Definition
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Term
At the time of birth, infants are often treated with erythromycin eye ointment as prophylactic treatment against what possible organism?
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Definition
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Term
The nurse is educating a patient newly diagnosed with open-angle glaucoma on the adverse effects of the indirect-acting miotic eye drops prescribed. What will the nurse include in the teaching as possible adverse effects? (Select all that apply.)
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