3. • Pilocarpine
originally from South American shrub: Pilocarpus
Pennatifolius
Used in treatment of Glaucoma
Available as 1-4% solution
CHRONIC SIMPLE GLAUCOMA
Longitudinal fibers of ciliary muscle attach to scleral
spur. Contraction pulls on Trabecular meshwork
resulting into increased outflow of aqueous and thus
reduction in intraocular prssure
4. • Acute Congestive Glaucoma
• used to constrict the pupil quickly
• Relieves pupil block
and aqueous begins to flow from posterior
chamber to anterior chamber and his results in
fall of IOP
Undesirable effects
Miosis causes poor night vision
Stimulation of ciliary muscle causes Accomodation
which leads to myopia
6. • Edrophonium
short acting anticholinesterase
increase amount of acetycholine at nerve endings.
Used to diagnose Myasthenia Gravis
Tensilon test
10 mg of edrophonium given IV
In myasthenia Gravis reief of Ptosis within a few
minutes
11. • ATROPINE SULPHATE
• Commonly used as 1% solution
1 Used in Treatment of Keratitis
Corneal ulcers and uveitis
Roles
a- Pupil Dilatation
Breaks down synechiae already formed
Prevents formation of new synechae
12. • b causes Cycloplegia
paralysis of accomodation
rests the eye
Relieves pain
Facilitates healing
c Stabilizes blood aqueous barrier
reduction in exudation from the blood
vessels
13. • 2 Atropine used in Refraction
To paralyse accomodation to determine
the Total hypermetropa
3 Atropine is used instead of occlusion to
force the amlyopic eye tosee in some cases of
squint
14. • Atropine can be absorbed from nasal mucosa
dry mouth
fever , delirium esp in children
Effect lasts 2weeks
15. • Scoplolamine 0.25%
• Homatropine 2%
Have same effect as atropine
Less powerful and duration of action shorter
16. • CYCLOPENTOLATE1%
• Parasympatholytic agent
• Short acting
• Effecs last less than 24hrs
• Uses
• 1 To dilate the pupil for fundoscopy
• 2 To dilate pupil before surgey
• 3 To paralyse ciliary muscle and therefore accomodation
during refraction.
• May be combined with 10% Phenyephrine to make
Mydriatic Cocktail . A more effective mydriatic in African
eyes
17. • Tropicamide
Marketed as Mydriacyl
Short acting mydriatic used to dilate pupil for
fundoscopy and preoperative.
18. • Sympathomimetic agents
Phenylephrine10 %
used to dilate pupil
May be combined with cyclopentolate in
Mydriatic cocktail
EPINEPHRINE or Adrenaline eye drops
Used in treatment of chronic simple glaucoma
19. • Sympatholytic agents
Beta blockers
TIMOLOL 1% or 0.5%
BETAXOLOL
used in chronic simple Glaucoma
and also in Secondary glaucoms
21. • Carbonic anhydrase inhibitors
Acetazolamide(Diamox)
used orally 250mg tablets 3 times a day.
Effective antiglaucoma medicine
But side effects
GIT anorexia
Nausea
Genital urinary
Frequent urination
ED
CNS
Extreme weakness
Depression
31. • Correct way Of putting eye drops in the eye
• Minimising absorption of eye drops in the
circulation.
• Routes of administering eye drugs
Topical
Suconjunctival
Subtenon
Intravitreal
Systemic
32. • Eye drops Vs eye ointments
Eye drops work quickly for a short time
And therefore applied more frequently
Eye ointments work slowly but for long periods
They can be used less frequently
Can be used at bedtime so that patient does
not wake up to put medicine
34. Anasthetics
Topical
used to anasthetise cornea for ocular procedures eg Tonometry
foreign body removal
Commonest Is Tetracaine also called Amethocaine
Injection
Lignocaine injection
Retrobulbar or Parabulbar for Anaethesia during intraocular surgery
And for Akinesia during surgery
To prevent squeezing of the eye by orbicularis muscle
Van Lint Technique or Obriens Method
35. FLUORESCINE
• Commonly used in Ophthalmology as a dye
sometimes on strips
Fluoescine strips
• Diagnosing corneal ulcers
• Staining cornea for Punctate Keratitis in
Dry eye
• Tear Break up Time measurement in Dry eye
• Dye Disappearence Test in Epiphora in JONES 1
and JONES 2 Tests
• Fluorescine Angiograghy used to see retinal
vessels in Dibetes especially
