Common Eye Drop Use in

Opthalmology

Antibacterial/ antifungal

Fluroquinolones

Aminoglycosides

Gentamycin

Others

Ciprofloxacin

Chloramphenicol

Antifungal
Natamycin

Amphotericin B

Fucithalmic
Bd dose
a/biotic agains Staph, Strep, Neisseria, Haemophylus,
Moraxella, & Corynebacteria
Indications bacterial eye infections caused by
susceptible organism in conjunctivitis, blepharitis, sty,
keratitis, dacrocystitis & in connection with removal of FB
CI known to have hypersensitivities
SE transient stinging, very low allergenic potential

Gentamycin
Genta eye drops recommended dose 4Hly, severe
infection 2hly
Aminoglycoside with bactericidal action. Inhibits protein
synthesis in susceptible bacteria. Active against a wide
range of gram ve organism eg. E coli, P aeroginosa,
Proteus spp, also some gram +ve org eg. Staph
Indication superf bacterial infections of the conjunctiva,
cornea, eyelids, tear pharitis, blepharoconjunctivitis,
keratitis, keratoconjunctivitis, episcleritis, dacrocystitis,
corneal ulcers, eyes & infected eye sockets
CI Sensitivity to any of the component
SE hypersensitivity reactions

Cloramphenicol
Active against common bacterial eye pathology

staph aureus
Streptococci
E coli
Haemophilus
klebsiella

For ocular infection: conjuctiva, cornea

CI: known hypersensitivity
SE: bone marrow hypoplasia/ aplastic anemia,
stinging, itching

Glaucoma

Alpha-adrenergic agonist

Beta-adrenergic antagonist

Pilocarpine hydrocloride

Prostaglandin

Dorzolamide 2% (Trusopt)

Miotics

Betaxolol 0.5% (betoptic) Bd

Timolol maleate 0.5% Bd

Carbonic anhydrase Inhibitor

Brimonidine titrate (alphagan-P) bd-tds

Latanoprost 0.005% (xalatan)

Symphatomimetic

Epinephrine 0.5,1,2% bd

Alpha-adrenergic agonist
Eg: Brimonidine titrate (alphagan-P)
Usual dose: bd-tds
Mechanism: inhibits aqueus secretion, posibble
increase uveoscleral outflow
Side effect: allergy, mydriasis, dry mouth, dry
eye, hypotension, lethargy
Contraindication: Monoamine oxidase inhibitor

Beta-adrenergic antagonist
Eg: Betaxolol 0.5% (betoptic), Timolol maleate

0.5%
Usual dose: Bd
Mechanism: decreased aqueous humor
production
Side effect: blurred vision, corneal anesthesia,
SPK, bradycardia, heart block, bronchospasm
Contraindication: asthma, severe COAD,
bradycardia, heart block, CCF

Betaxolol 0.5% (Betoptic)

A cardioselective (beta-1-adrenergic) receptor blocking
agent
Indication effective in lowering IOP and may be used in
pts with chronic open-angle glaucoma and ocular HPT
CI Hypersensitivity to the component, sinus brady,
greater than a 1st degree AV block, cardiogenic shock or
pts with overt cardiac failure
SE transient ocular discomfort, blurred vision, corneal
punctate keratitis, dryness of eye, etc

Timolol
Timolol maleate
Beta 1 and beta 2 adrenergic receptor blocking agent
Reducing elevated and normal IOP whether or not
accompanied by glaucoma
Exact mechanism not been clearly defined
Indication elevated IOP in patients with ocular HPT or
open angle glaucoma
CI pts with B. asthma, severe COPD, sinus
bradycardia, 2nd or 3rd degree AV block, cardiac failure,
cardiogenic shock, hypersensitivity to any component of
the product
SE local irritation, bronchoC in elderly pts with COPD

Carbonic anhydrase Inhibitor

Eg: Dorzolamide 2% (Trusopt)
Usual dose: Bd-tds
Decreased aqueous production in cilliary body
Side effect: bitter taste, diuresis, GI
upset,aplastic anaemia, Stevens-Johnson
syndrome
Contraindication: Sulfa allergy, hyponatremia,
hypokalemia, renal stone

Miotics
Eg: Pilocarpine hydrocloride (Isopto Carpine)
solution 0.25%-8%
Usual dose: bd-qid
Increased trabecular outflow
Side effect:
Contraindication:

Pilocarpine Hydrochloride
Isopto carpine
Direct acting cholinergic parasympathomimetic agent which
acts through direct stimulation of muscarinic neuro receptors &
smooth muscle such as the iris and secretory glands
Contraction of iris spincter > Increase tension on scleral spur
and opening of TM spaces to facilitate outflow of aqueus
Indications to control IOP as a miotic (parasympathomimetic)
CI acute iritis, known to have hypersensitivity, pupillary block
glaucoma
SE transient stinging & burning, ciliary spasm, conjunctival
vasc congestion, temporal/supraorbital headache and induced
myopia may occur

Prostaglandin
Eg: Latanoprost 0.005% (xalatan)
Increased uveoscleral outflow
Side effect: blurred vision, eyelid
redness,cme,ant uveitis, myalgia
Contraindication: pregnancy, inflammatory
condition

Symphatomimetic

Mydfrin 2.5%

Phenylephrine hydrochloride
An alpha receptor sympathetic agonist used in local ocular disorder
bcoz of its vasoC & mydriatic action.
Indication as a vasoC, decongestant & mydriatic in a variety of
ophtalmic conditions & procedures, pupillary dilatation in uveitis,
ophtlmic surgical procedures & for refraction without cyclopegia
CI pts with anatomically narrow angles or narrow angle glaucoma,
LBW infants, elderly adult with severe arteriosclerotic cardiavascular
or cerebrovasc disease, disturbed corneal epithelial barrier during
intraocular op preocedures & known to have hypersensitivities
SE marked increased BP, cardiovasc reactions, syncope, MI,
tachy, arrhytmia and fatal subarachnoid hhage

Anti-Inflammatory

NSAIDS

Antihistamines

Cromolyn sodium

Corticosteroids

Ketorolac acular 0.5%

Fluoromethalone 0.1,0.25,%
Betnesol

Combination steroid and antibiotic

maxitrol

Betnesol N

Acular
Ketorolac tromethamine
Is a NSAID (analgesic, anti-inflammatory & anti-pyretic),
action by the ability to inhibit prostaglandin biosynthesis
Indication short term relief of ocular itching d/t
seasonal allergic conjunctivitis, prophylaxis and
reduction of inflammation and associated symptoms
following ocular surgery
CI known to have hypersensitivity, avoid at late
pregnancy
SE transient stinging and burning in instillation, ocular
irritation, allergic reactions, superf ocular infections &
superficial keratitis

Maxitrol

Dexamethasone, neomycin, polymyxin B sulfate

Corticoids suppress the inflammatory response to a variety of
agents
Indication ocular inflammation when concurrent use of an
antimicrobial is judged necessary,supress inflammatory response
CI epithelial herpes simplex keratitis, vaccinia, varicella, and many
other viral diseases of the cornea & conjunctiva. Mycobacterial
infection of the eye. Fungal diseases of ocular structures. Known to
have hypersensitivities.
SE allergic sensitizations, elevation of IOP, optic nerve damage,
posterior subcapsular cataract formation & delayed wound healing

Lubricating

Solcoseryl eye-gel
3-4 times /day
Contain benzalkonium choride as preservative
Promote healing
treatment of disorders & injuries affecting the cornea &
conjunctiva of the eye
CI any persons known to have hypersensitivity to its
ingredients
SE Stinging may occasionally occur briefly on admin

Dacrolux /artificial tears

Relieves the eye dry symptom by reestablishing the tear
film
Indications cases requiring additional lubrication as
symptomatic relief of dryness of the eye d/t the use of
contact lenses, dust, smog
CI known to have hypersensitivity
SE none are known

Isopto-Atropine
Potent parasympatholytic agent
Indication for the production of mydriasis & cyclopegia.
- For refraction or
- for iris dilation desire in acute inflammatory conditions
of the iris & uveal tract (tds)
CI pts with glaucoma or a tendency toward glaucoma
SE - local irritation resulting in congestion, edema,
eczema, & follicular conjunctivitis

Homatropine Hydrobromide
Isopto Homatropine
Anticholinergic
Moderate Long acting mydriatic and
cyclopegic for cycloplegic refraction
Treatment of inflammotory condition of
uveal tract (3-4hly)
CI: primary glaucoma eg: narrow angle
SE: transient stinging and burning