drug relative to eyes with their meiotic and mydriatic effect. In the presentation discus about spasm of accommodation and cycloplegic action on eye . pharmacological action , dosage also discussed of condition developed on eye i.e. Glaucoma

1. DRUG ACTING ON
EYE
Swati G. Patil
M . Pharm
Pharmaceutics

2. Eye is the special sense
organ of the sight , having
limited systemic access by
blood-retinal , blood-
aqueous and blood-
vitreous barrier. Because
of which the eye exhibit
unusual characteristics .
Eye abnormalities include
myopia ( near sightedness
) , hyperopia (far
sightedness ) ,
Presbyopia, cataract,
Introduction

4. • These are Pharmacological agent Producing mydriasis are
known as Mydriatics. Mydriasis means dilation of pupil.
There are the two types of muscles in the iris that
regulate the size of pupil .
• These are the circular muscle ( sphincter muscles) and
radial muscles (dilator) .
Mechanism :
• Pupilae supplied by parasympathetic as well as
sympathetic nerve fibre .
• The parasympathetic supply is through occulomotor
nerve and supplies constrictor pupilae i.e. circular muscle
fibres. The sympathetic supply is through superior
cervical ganglion and supplies to dilator pupilae.
• When Mydriatics instilled in the eye , it causes relaxation
of circular muscle fibre, i.e. constrictor pupilae and

5. • This caused flattening lens which is
referred as Mydriasis.
Because of Mydriasis, focal length of pupil
is also increase which is fix the sight for far
vision, i.e. person can see the object which
far away but fails to observe those that are
too near , this termed cyclopegia.

6. • Miosis means constriction of pupil And the agent
that produce meiosis are called as Miotics.
Mechanism:
Pupilae supplied by parasympathetic as well as
sympathetic nerve fibre .
• The parasympathetic supply is through
occulomotor nerve and supplies constrictor
pupilae i.e. circular muscle fibres.
• When Miotics are instilled in the eye , the causes
contraction of circular muscle fibre, i.e.
constrictor pupilae and relaxation of radial
muscle fibre i.e. dilator pupilae.
This caused marked reduction in size of pupil whish
is referred as miosis.

7. Because of Miosis , focal length of
pupil is also reduced, person can see
the object which are near but fails to
observe those that are far away , this
termed as spasm of accommodation

8. [A] Mydriatics and
cycloplegics
[B] Miotics and Spasm of
accommodation
1.Parasympatholitics 1. Parasympathomimetics (
cholinergic)
Atropine
Homotropin
Cyclopentolate
Tropicamide
Scopolamine
Acetylcholine
Methacholin
Carbachol
Pilocarpine
Physostigmine
Edrophonium
2. Sympathomimetic 2. Sympatholytic
Adrenaline
Phenylephrine
Cocaine
Ephedrine
Gaunethedine
Tolazoline
Dibenamine
Drug acting on eye ball are classified as :

9. Drugs
 Miotics
1. Physostigmine
• Physostigmine potentiate the muscarinic like action of acetyl
choline by antagonism of cholinesterase to cause Miosis ,
ciliary spasm and fixing of lens for near vision.
• The intraocular pressure may fall due to the opening of
filtration angle by stretched iris which is facilitate
reabsorption of the aqueous humor.
• Accommodation returns to normal in 3 hours but Miosis start
in few minute, is maximal in 30 minutes band may not wear
off for several days.
• Physostigmine is used to treat glaucoma or to counteract the
effect of Mydriatics.
• Drug with similar effect are Ecothiopate ( long acting
cholinesterase) and pilocarpine , an alkaloid which stimulate

10. Adrenergic drug like Dibenamine which is alpha-
adrenergic receptor blocker produce Miosis by
causing relaxation of radial muscle (dilator) . It dose
not affect accommodation and intraocular tension .
Dibenamin
e

11. • Pilocarpine It is cholinergic agonists . Primarily
used in treatment of glaucoma , used in the form
of eye drop solution pilocarpine hydrochloride
2%, 4% and pilocarpine nitrate 2 %, 4% , one drop
up to four times daily.
• Indications : Chronic open-closure glaucoma ,
ocular hypertension an din emergency treatment
of acute angle-closure glaucoma.
• Contraindication : Acute iritis, Acute uveitis,
inflammation of anterior segment.
• Adverse effect : Eye pain , blurred vision ,ciliary
spasm, lacrimation, myopia.
Pilocarpin
e

12. • A specific beta-adrenergic blocker drug. It is
combined with carbonic anhydrase inhibitor ,
dorzolamide in a single medication. Such
combination reduces the number of drop
needed and may improve compliance .
• Indication : Ocular hypertension , chronic
open-angle glaucoma.
• Contraindications : Uncontrolled heart failure
, bradycardia heart block , asthma.
• Dosage : Eye drops instillation 1 drop ( 0.25
% or 0.5 % ) twice daily.
Timol
ol

13. • Mydriasis can produced by
sympathomimetic drug like adrenaline
and phenylpepinefrine .
• These drug dilate the pupil though have
little effect on accommodation .
• The intraocular pressure may fall.
• Cocaine also stimulate adrenergic
mechanisms to give similar effect.
Mydriatic
s
Mydriatics

14. • Mydriasis can also be produced by anticholinergic drug like
atropine and Homotropin. These drugs antagonize the
muscarinic like action of acetyl choline . These drug produce
dilation of the pupil ( i.e. mydriasis ) paralysis of
accommodation (i.e. cyclopegia) with fixation of the lens for
vision.
• A 1% of solution of atropine instilled into the conjunctival sac
produces maximal dilation of pupil in about 30-60 minutes for
7-10 days. More than an hour may be necessary for the
paralysis of accommodation which persist 3-5 days.
• Mydriatics such as atropine are used to dilate the pupil to
facilitate ophthalmological examination . In the inflammation
of iris , they will rest the eye and the dilating of the pupil will
keep the iris away from the lens and prevent adhesions . The
persistent mydriasis may cause blockade for the filtration angle

15. • Anticholinergic drug atropine by blocking
muscarinic cholinergic effects paralyze the pupillary
constrictor muscle resulting into dilation of pupil (
mydriasis ). In the addition the paralysis of ciliary
muscle result into paralysis of accommodation (
cyclopegia ) .
• Therapeutic uses/ Indications: It is used for
cycloplegics refraction procedures , particularly in
children , iris , uveitis, Antispasmodic etc.
• Dosage : Atropine Sulfate eye drops , solution 0.1
% . 0.5% and 1 %.
• Contraindications : Angle-closure Glaucoma.
Atropine

16. Drug used in
Glaucoma
• Glaucoma is an ocular disease
characterized by elevated
intraocular pressure which causes
damage of optic nerve head
producing visual loss.
• The damage to optic nerve head
and visual loss is probably due to
ischemia and may be attributed to
direct pressure on nerve.
Objective of management of

17. The various agent used are as follows :
1.Beta adrenergic blocker : Timolol , betaxolol ,
levobunolol
They are the beta blockers effective in glaucoma. They
act by
reducing the formation of aqueous humour.
2. Miotics : Pilocarpine and physostigmine .
They produce contraction of ciliary muscle .
3. Alpha adrenergic agonist : Apraclonidine and
brimonidine.
Both are congeners of clonidine. They act by decreasing
aqueous
humour production.
4. Carbonic anhydrase inhibitor: Acetazolamide
belongs to this
group . It acts by inhibiting the generation of