O
phthalmic agents are drugs that are
intended for direct administration into
the conjunctiva of the eye. These drugs
are used to treat glaucoma (miotics
constrict the pupil and decrease the
resistance to aqueous flow); to aid in
the diagnosis of eye problems (mydri-
atics dilate the pupil for examination
of the retina; cycloplegics paralyse the
muscles that control the lens to aid
refraction); to treat local ophthal-
mic infections or inflammation; and
to provide relief from the signs and
symptoms of allergic reactions.
These drugs are not generally
absorbed systemically because of
their method of administration.
Caution should always be used when giving drugs
during pregnancy or breastfeeding.
Contraindications and cautions
These drugs are contraindicated in the presence of
allergy to the specific drug or to any component of the
product being used. Although they are seldom absorbed
systemically, caution should be used in any person who
would have problems with the systemic effects of the
drugs if they were absorbed systemically.
Adverse effects
Adverse effects of these drugs include local irritation,
stinging, burning, blurring of vision (prolonged when
using ointments), tearing and headache.
Clinically important drug–drug interactions
Because of their actions on the eye or because of the
components of the drug, many of these drugs cannot be
given at the same time but should be spaced 1 to 2 hours
apart. Check the specific drug being used for details.
Dosage
The usual dosage for any of these drugs is one to two
drops in each eye or in the affected eye two to four times
daily, or 0.5–1 cm in the affected eye or eyes.
Appendix
Ophthalmic agents
D
Care considerations
Assessment
■
■
Screen for the following: allergy to the specific
drug or components of the preparation; underlying
medical conditions
that would be affected if the
drug were absorbed systemically
.
■
■
Evaluate eye, conjunctival colour; note any lesions.
A vision examination may be appropriate.
Implementation
■
■
Assess the person’s general physical condition
before beginning the test
to decrease the potential
for adverse effects
.
■
■
Follow these administration guidelines to
provide
the most therapeutic use of the drug with the
fewest adverse effects
:
–– Solution or drops: Wash hands thoroughly before
administering; do not touch the dropper to the
person’s eye or to any other surface. Have the
person tilt the head backwards or lie down, and
have the person stare upwards. Gently grasp the
lower eyelid and pull the eyelid away from the
eyeball; instil drops into the pouch formed by
the eyelid. Release the lid slowly; have the person
close the eye and look downwards. Apply gentle
pressure to the inside corner of the eye for 3 to
5 minutes to retard drainage. Do not rub the
eyes; do not rinse the eyedropper. Do not use eye
drops that have changed colour; if more than one
type of eye drop is used, wait at least 5 minutes
between administrations. Refer to Figure D.1.
–– Ointment: Wash hands thoroughly before
administering; hold the tube between the hands
for several minutes to warm the ointment; discard
the first centimetre of ointment when opening
the tube for the first time. Tilt the person’s head
backwards or have the person lie down and stare
upwards. Gently pull out the lower lid to form
a pouch; place 1–1.5 cm of ointment inside the
lower lid. Have the person close the eye for 1 to
2 minutes and roll the eyeball in all directions;
remove any excess ointment from around the eye.
If using more than one kind of ointment, wait at
least 10 minutes between administrations. Refer
to Figure D.2.
