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PHARMACOLOGY OF THE EYE

PHARMACOLOGY OF THE EYE. Prepared By: Dr./ Rehab Lashine Pharmacology Department. Physiological Anatomy of the Eye. THE ANT.CHAMBER OF THE EYE. The Ciliary Body. The Pupil. Pupillary Muscles. Mydriasis. Miosis. Effect of Miosis and Mydriasis on Acquous Humor Drainage. Accomodation.

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PHARMACOLOGY OF THE EYE

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  1. PHARMACOLOGY OF THE EYE Prepared By: Dr./ Rehab Lashine Pharmacology Department

  2. Physiological Anatomy of the Eye

  3. THE ANT.CHAMBER OF THE EYE

  4. The Ciliary Body

  5. The Pupil

  6. Pupillary Muscles

  7. Mydriasis

  8. Miosis

  9. Effect of Miosis and Mydriasis on Acquous Humor Drainage

  10. Accomodation

  11. Autonomic Nerve supply of the Eye • Parasympathetic: 1- Bl.Vs. …Conjuctival VD ( Oculomotor) 2- Ciliary mm.. (Accomodation) (Oculomotor) 3- Sphincter pupillae(Miosis) (Oculomotor) 4- Increased lacrimation…..7th vranial n. (N.B.: Stim. Of the nic. Rec. causes twitches of eye lid mm.)

  12. Sympathetic 1- Bl.Vs.( Conjunctival VC)………α1 2- Dilator Pupillae ( Mydriasis)…….. α1 3- Levator palpebrae & Muller’s m.(Exophthalmus & widening of the palpebral fissure)….. 4- Ciliary mm (relaxation)……. β2 5- Lacrimal glands (lacrimation)………α1 6- α & β rec. in the Bl.vs. of the ciliary processes….help in regulation of aqueous humour formation

  13. Light Reflex

  14. Corneal Reflex

  15. Drugs Acting on the Eye I- Drugs affecting the size of the pupil: • Miotics • Mydriatics II- Drugs Affecting Accomodation….Cycloplegics III- Drugs affecting the IOP (intraocular pressure) IV- Local Anesthetics V- Antiallergic agents VI- TTT of Eye Infection

  16. Miotics • M3 rec.: Parasympathomimetics • α1 blockers: Sympatholytics(e.g.Phenoxybenzamine) • Central : Morphine ( ↑oculomotor nucleus) USES: -Glaucoma -Counteract action of mydriasis - To break adhesions

  17. Mydriatics • Active: - Sympathomimetics….(Mydriasis without Cycloplegia or loss of light reflex) - Local anesthetics…..(Cocaine) (Mydriasis without Cycloplegia or loss of light reflex ). • Passive: - Anticholinergics……(Mydriasis with Cycloplegia & loss of light reflex) except Eucatropine (doesn’t cause cycloplegia). • Ganglion Blockers …...(Mydriasis with Cycloplegia ) • Central USES: Fundus Exam, Therapy of acute Iritis, Breaking Adhesions

  18. Drugs Affecting Accomodation • Drugs causing Accomodation to near objects: - stim. of ciliary mm: Parasympathomimetics • Cycloplegics: drugs causing paralysis of ciliary mm…..loss of accomodation…fixation of vision for far vision: Parasympatholytics (EXCEPT EUCATROPINE)

  19. N.B.: • Sympathomimetic mydriatics are safely used in adults > 40 years in whom Atropine have the risk of causing dangerous rise in IOP. • Therapeutic uses of Cycloplegic drugs: 1- Ttt of Iridicyclitis 2- Ttt of choroiditis 3- Measurement of refractive errors

  20. Drug Therapy of Primary Open Angle (chronic simple) Glaucoma A) Miotics: They act mainly by↑ the acqueous outflow. 1- Direct : pilocarpine. 2- Indirect: choline esterase inhibitors B) Sympathomimetics: ↓ acq.humour production, & ↑ outflow C) Β-adrenoceptor blocking agents: ↓ acq.humour production…….Timolol, befunolol D) Oral Agents: Carbonic Anhydrase inhibitors. ↓ acq.humour production…..Acetazolamide

  21. Drug Therapy of acute angle closed (congestive) glaucoma • Dehydrating agents: IV infusion Of Hypertonic solution ( Mannitol, Glycerol) • Oral Acetazolamide • Topical miotics: e.g.: pilocarpine • Analgesics: pethidine or morphine (for pain)

  22. Drug used in treating inflammatory and allergic eye conditions • 1- Conjunctivitis: can be ttted by: A- Penicillin G, chloramphenicol ( Acute purulent conj.) B- Sulphacetamide (eye drops)..for trachoma C- Tetracycline ….for chronic follicular conjunctivitis D- Vidarabine, or Acyclovir for Herpes simplex keratitis E- Topical steroids for chronis puppillary conj.

  23. Drug used in treating inflammatory and allergic eye conditions( Cont.) 2- Glucocorticoids: to suppress inf., and allergy 3- Topical Antihistaminics: (eye drops), in allergies 4- Sodium cromoglycate: ( for ttt. Of spring catarrh, vernal keratoconjunctivitis) 5- Astringents : Zinc Sulphate ( angular conj.)

  24. Harmful drugs for the Eye 1- Drugs that ↑ IOP: A- Mydriatic cycloplegics, tricyclic antidepressants B- Chronic steroid use 2- Cataractogenic drugs:steroids, phenothiazines, heavy metals… 3- Drug-induced retionopathies:ethanol, methano, indomethacin,steroids 4- Drugs causing corneal deposits:Amiodarone, chloroquine… 5- Oculomucocutaneous syndrome( Conj. Fibrosis, corneal opacities,and dimnished tear secretion) e practolol 6- O2 :40 % for prolonged periods in premature infants causes Retrolental fiboplasia

  25. Experiment

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