ISSN 2398-2950      

Therapeutics: eye

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Administration of drugs to eye

  • Both local and systemic routes are available. Local routes include topical, subconjunctival and intravitreal.
  • Choice of route of administration depends on location of disease (eg eyelids, ocular surface, anterior segment, posterior segment), pharmacology of drug (eg ability to penetrate cornea and blood-ocular barriers), potential for systemic side effects and availability of drug preparations.
  • Subconjunctival administration is reserved when topical application is not possible or the disease is not responding to topical therapy. Following topical anesthetic the drug is injected under bulbar conjunctiva.
  • Intravitreal injections are rarely performed.
  • Systemic therapy is needed to reach therapeutic drug levels in the eyelids and posterior segment.

Topical drug preparations

  • Drop and ointment forms exist and should be applied directly to the surface of the eye, eg lower conjunctival sac or cornea.
  • Drops easier to apply but have decreased ocular surface contact times necessitating more frequent application.
  • Ointments have prolonged corneal contact time, require less frequent application, have lubricating properties but can cause blurring of vision.
  • Corneal penetration and intraocular delivery of topical drugs is variable. To penetrate the corneal epithelium and stroma the drug should have both lipophilic and hydrophilic properties.
  • Most topical drug formulations contain preservatives such as benzalkonium chloride Benzalkonium chloride. These can be irritating and epitheliotoxic.
  • If more than one drug preparation is to be applied, separate administration by >5 min.
  • Topically applied drugs can have systemic effects, eg atropine, phenylephrine and corticosteroids.

Anti-infective eye preparations

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Anti-inflammatories

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Mydriatics and cycloplegics

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Anti-glaucoma medications

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Keratoconjunctivitis sicca

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Further Reading

Publications

Refereed papers

Other sources of information

  • Ramsey I (2008) BSAVA Small Animal Formulary. 6th edn. British Small Animal Veterinary Association. ISBN 978 1 905319 11 4.
  • British National Formulary (2008) 55th edn. BMJ Group and RPS Publishing.
  • Petersen-Jones S & Crispin S (2002) BSAVA Manual of Small Animal Ophthalmology. 2nd edn. British Small Animal Veterinary Association. ISBN 0 905214 54 4

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