Treatment of certain Eye Conditions by Dr GL Muntingh Dept of Pharmacology

1. Treatment of certain Eye ConditionsbyDr GL MuntinghDept of Pharmacology

2. The most common eye infections are: Viral ØConjunctivits: Allergic Bacterial ØSties ØBlepharitis

3. The three most common types of conjunctivitis are: Two specific 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 1. Viral • ·Watery discharge • ·Burning • ·Irritation • ·Glossy looking redness • ·Infection usually begins with one eye, can spread. • Often follows URT infection  adenovirus

4. ‘Pink Eye’

5. 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.

6. 2. Allergic • ·Usually affects both eyes • ·Itching • ·Tearing • ·Swollen eyelids • Watery or stringy discharge

7. 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 anti-inflammatory 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

8. 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.

9. 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! "

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. Blepharitis… Posterior blepharitis: This is when the meibomian gland orifices clog up. When examining the eyelids, always push on the lid edges with a Q-Tip. If pus-like material oozes out of the pores, then you know the gland isn’t draining properly.

17. 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

18. Antibiotics commonly used topically in the treatment of bacterial eye infections: Chloramphenicol Gentamycin OfloxacinNeomycin Polymixin Tobramycin Sulphacetamide Tetracyclines

19. Hang-Over-Headache?

20. 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.

22. Open-angle Glaucoma

23. Closed-angle Glaucoma

24. Glaucoma treatment

25. Glaucoma treatment….