Treatment of certain Eye Conditions
by
Dr GL Muntingh
Dept of Pharmacology
The most common eye infections are:
Viral
 Conjunctivits:
Allergic
Bacterial
 Sties
 Blepharitis
The three most common types of conjunctivitis
are:
Two specific
1. Viral
signs on exam
are enlarged
follicular bumps
on the inside of
the eyelids
(these look like
tiny blisters) and
swelling of the
preauricular
node located in
front of the ear

Watery discharge

Burning

Irritation

Glossy looking redness

Infection usually begins with one eye, can spread.
•
Often follows URT infection  adenovirus
‘Pink Eye’
Treatment:
Most common & usually >50% cases in adults
There is no cure for viral conjunctivitis
Symptoms can be relieved with cool compresses
and artificial eye lubrication
Herpes simplex kerititis – Acyclovir oitment
Topical steroid drops to reduce discomfort from
inflammation or diclofenac eye drops
Viral conjunctivitis usually resolves within 3 weeks.
2. Allergic

Usually affects both eyes

Itching

Tearing

Swollen eyelids
•
Watery or stringy discharge
Treatment for allergies:
• Remove the allergen if possible. Cool
compresses and artificial tears sometimes
relieve discomfort in mild cases.
• In more severe cases, non-steroidal antiinflammatory e.g. diclofenac eye drops
• Some patients with persistent allergic
conjunctivitis may also require:
- Topical antihistamines e.g. antazolin, phenylephrine,
levocabastine
- Topical steroid drops e.g. betamethasone, dexamethasone
- Mast Cell Stabilizers: Sodium Chromoglycate
3. Bacterial

Purulent (pussy) discharge. Lids often stick
together overnight.

Swelling of the conjunctiva  meaty Redness

Tearing

Irritation, pain and/or a gritty feeling
•
Usually affects only one eye, often spreads 2nd eye.
Bacterial eye infections
It is caused by bacterial growth
and characterized by a thick
yellow discharge from the eye,
often enough to stick the eye
shut overnight.
It is contagious not just to the
neighbor eye but also other
persons especially children and
therefore should be treated
ASAP
Children especially those in
crèches and primary school
should be kept @ home
"Ha! no School for me
Today! "
Most common causes are Staph and Strep, although
with children you should also consider Hemophilus
influenza.
In addition, sexually active adults may harbor
chlamydial and gonococcal infections (especially with
severe or sudden discharge).
Gonococcal conjunctivitis requires intravenous or
intramuscular antibiotics in addition to topical therapy
Sties
A sty (hordeolum) is a red,
painful lump on the edge or
inside of your eyelid that may
look like a boil or a pimple.
Usually a sty is filled with pus.
As it swells in size, the sty may
make it difficult for you to see
clearly because you can't fully
open your eye
Sties..
Most sties eventually fill with pus and then rupture.
The release of pus relieves one major symptom of
sties - pain. Usually the sty then disappears.
•
•
•
•
•
•
•
Symptoms of sties include:
Pain
A red lump similar to a boil or a pimple
Swelling on your eyelid
Light sensitivity
A scratchy sensation in your eye
Tearing
Sties
Causes
• a bacterial infection, usually
staphylococcus.
• Usually the bacterial infection develops at
the (follicle) of an eyelash. You may have
more than one sty at a time or several in
succession
Sties….
• Wash eyelids and eyelashes several times a day using
mild soap. Be sure eyes are closed tightly when washing
eyes with soap. Eyelid hygiene is key to treat a sty and
to keep from getting them.
• Abstain from wearing contact lenses / cosmetics while
there is a sty and keep the eyelid area clean.
• Apply warm compresses to the area of the sty for 15
minutes, 2 to 3 times a day.
• Topical Ophthalmic antibiotic as needed
Blepharitis

Blepharitis means inflammation (itis) of the
eyelids (bleph), specifically the eyelid margin.
Anterior blepharitis:
With these patients you’ll find a
buildup of debris, or “scurf”,
that form as collarets at the base
of the eyelashes.
Bacteria and irritants live in this
debris and constantly shed
irritants into the tear film. If
severe, you can see small
ulcerations and eyelash loss in
affected areas
Blepharitis…
Posterior blepharitis:
This is when the
meibomian gland orifices
clog up. When examining
the eyelids, always push
on the lid edges with a QTip. If pus-like material
oozes out of the pores,
then you know the gland
isn’t draining properly.
Blepharitis…
Burning, itching, or a feeling of having something in the
eye.

Crust on the eyelids that makes them stick
together in the morning. Red and sore eyelid edges.

Eyelash loss.

Sometimes, lice that can be seen on the lashes.
Treatment: topical antibiotic
Antibiotics commonly used topically in
the treatment of bacterial eye infections:
Chloramphenicol
Ofloxacin
Polymixin
Sulphacetamide
Gentamycin
Neomycin
Tobramycin
Tetracyclines
Hang-Over-Headache?
Glaucoma
• Think of your eye as a sink, in which the faucet is
always running and the drain is always open.
• The aqueous humor is constantly circulating through
the anterior chamber. It is produced by a tiny gland,
called the ciliary body, situated behind the iris.
• It flows between the iris and the lens and, after
nourishing the cornea and lens, (≈ 80%) flows out
through a very tiny spongy tissue, called the
trabecular meshwork, which serves as the drain of
the eye; 20% drains the via uveoscleral route
• The trabecular meshwork is situated in the angle
where the iris and cornea meet.
Open-angle Glaucoma
Closed-angle Glaucoma
Glaucoma treatment
Beta blockers:
Timolol
reduce the production of
aqueous humor
bronchospasm,
fatigue, erectile
dysfunction, bradycardia
Alpha-adrenergic
agents.apraclonidine,
brimonidine
Decrease aqueous
production; may
increase uveoscleral
aqueous outflow
itchy or swollen eyes; dry
mouth; and allergic
reactions. Headaches burning
of the eyes
Carbonic anhydrase inhibitors: Reduce the amount of
dorzolamide
aqueous humor
S/e include frequent urination
and a tingling sensation in the
fingers and the toes
Prostaglandin analogues:
latanoprost
stinging of the eyes, darkening
of the iris, changes in the
pigment of the eyelid skin,
swelling of the central retina
Increase uveoscleral
outflow rather than altering
conventional aqueous
outflow
Glaucoma treatment….
bimatoprost
increase the outflow of
aqueous humor
Possible side effects
include mild to moderate
reddening of the eyes and
itchy eyes.
Miotics: pilocarpine,
carbachol
increase the outflow of
aqueous humor
include pain around or
inside the eyes, brow
ache, blurred or dim
vision, nearsightedness,
allergic reactions, a stuffy
nose, sweating, increased
salivation
Prostamides: