Eye Drops
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Eye drops or eyedrops are liquid drops applied directly to the surface of the eye usually in small amounts such as a single drop or a few drops. Eye drops usually contain saline to match the
salinity Salinity () is the saltiness or amount of salt (chemistry), salt dissolved in a body of water, called saline water (see also soil salinity). It is usually measured in g/L or g/kg (grams of salt per liter/kilogram of water; the latter is dimensio ...
of the eye. Drops containing only saline and sometimes a lubricant are often used as artificial tears to treat
dry eyes Dry eye syndrome (DES), also known as keratoconjunctivitis sicca (KCS), is the condition of having dry eyes. Other associated symptoms include irritation, redness, discharge, and easily fatigued eyes. Blurred vision may also occur. Symptoms rang ...
or simple
eye irritation The human eye is a sensory organ, part of the sensory nervous system, that reacts to visible light and allows humans to use visual information for various purposes including seeing things, keeping balance, and maintaining circadian rhythm. T ...
such as itching or redness. Eye drops may also contain one or more medications to treat a wide variety of eye diseases. Depending on the condition being treated, they may contain
steroids A steroid is a biologically active organic compound with four rings arranged in a specific molecular configuration. Steroids have two principal biological functions: as important components of cell membranes that alter membrane fluidity; and ...
,
antihistamine Antihistamines are drugs which treat allergic rhinitis, common cold, influenza, and other allergies. Typically, people take antihistamines as an inexpensive, generic (not patented) drug that can be bought without a prescription and provide ...
s,
sympathomimetic Sympathomimetic drugs (also known as adrenergic drugs and adrenergic amines) are stimulant compounds which mimic the effects of endogenous agonists of the sympathetic nervous system. Examples of sympathomimetic effects include increases in hea ...
s, beta receptor blockers, parasympathomimetics, parasympatholytics,
prostaglandin The prostaglandins (PG) are a group of physiologically active lipid compounds called eicosanoids having diverse hormone-like effects in animals. Prostaglandins have been found in almost every tissue in humans and other animals. They are deriv ...
s,
nonsteroidal anti-inflammatory drug Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration o ...
s (NSAIDs),
antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention ...
s,
antifungals An antifungal medication, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis (thrush), serious systemic infections such as cryp ...
, or
topical anesthetic A topical anesthetic is a local anesthetic that is used to numb the surface of a body part. They can be used to numb any area of the skin as well as the front of the eyeball, the inside of the nose, ear or throat, the anus and the genital area. T ...
s. Eye drops have less of a risk of side effects than do oral medicines, and such risk can be minimized by occluding the lacrimal punctum (i.e. pressing on the inner corner of the eye) for a short while after instilling drops. Prior to the development of single-use pre-loaded sterile plastic applicators, eye drops were administered using an eye dropper, a glass pipette with a rubber bulb.


Shelf life

Although most bottles of eye drops contain preservatives to inhibit contamination once opened, these will not prevent contamination indefinitely. Ophthalmologists recommend keeping bottles for no longer than three months after opening. Eye drops that contain no preservatives are usually packaged in single-use tubes. Dispensers typically oversize the drops; the human eye can only handle about 25 microlitres.


Types and uses

Different pharmacological classes of eye drops can be recognized by patients by their different colored tops. For instance, the tops to dilating drops are a different color than anti-allergy drops.


Dry eyes

Eyes drops sometimes do not have medications in them and are only lubricating and tear-replacing solutions. There is a wide variety of artificial tear eye drops that provide different surface healing strategies. One can find bicarbonate ions,
hypotonicity In chemical biology, tonicity is a measure of the effective osmotic pressure gradient; the water potential of two solutions separated by a partially-permeable cell membrane. Tonicity depends on the relative concentration of selective membrane ...
, high
viscosity The viscosity of a fluid is a measure of its resistance to deformation at a given rate. For liquids, it corresponds to the informal concept of "thickness": for example, syrup has a higher viscosity than water. Viscosity quantifies the int ...
gels and ointments, and non-preserved types. They all act differently and therefore, one may have to try different artificial tears to find the one that works the best.


Steroid and antibiotic eye drops

Steroid and antibiotic eye drops are used to treat eye
infections An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable di ...
. They also have prophylactic properties and are used to prevent infections after eye surgeries. They should be used for the entire time prescribed without interruptions. The infection may relapse if the use of the medication is stopped.


Pink eye

Antibiotic eye drops are prescribed when infection
conjunctivitis Conjunctivitis, also known as pink eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. Th ...
is caused by bacteria but not when it is caused by a virus. In the case of allergic conjunctivitis, artificial tears can help dilute irritating allergens present in the tear film.


Allergies

Some eye drops may contain histamine antagonists or
nonsteroidal anti-inflammatory drug Non-steroidal anti-inflammatory drugs (NSAID) are members of a therapeutic drug class which reduces pain, decreases inflammation, decreases fever, and prevents blood clots. Side effects depend on the specific drug, its dose and duration o ...
(NSAIDs), which suppress the optical mast cell responses to allergens including (but not limited to) aerosolized dust particles.


Glaucoma

Eye drops used in managing
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
help the eye's
fluid In physics, a fluid is a liquid, gas, or other material that continuously deforms (''flows'') under an applied shear stress, or external force. They have zero shear modulus, or, in simpler terms, are substances which cannot resist any shear ...
to drain better and decrease the amount of fluid made by the eye which decreases eye pressure. They are classified by their active ingredient and they include: prostaglandin analogs, beta blockers, alpha agonists, and carbonic anhydrase inhibitors. There are also combination drugs available for those patients who require more than one type of medication.


Mydriatic eye drops

These make the eye's
pupil The pupil is a black hole located in the center of the Iris (anatomy), iris of the Human eye, eye that allows light to strike the retina.Cassin, B. and Solomon, S. (1990) ''Dictionary of Eye Terminology''. Gainesville, Florida: Triad Publishing ...
widen to maximum, to let an
optometrist Optometry is a specialized health care profession that involves examining the eyes and related structures for defects or abnormalities. Optometrists are health care professionals who typically provide comprehensive primary eye care. In the Un ...
have the best view inside the eyeball behind the iris. Afterwards in sunny weather they can cause dazzling and photophobia until the effect of the mydriatic has worn off. In some countries including
Russia Russia (, , ), or the Russian Federation, is a transcontinental country spanning Eastern Europe and Northern Asia. It is the largest country in the world, with its internationally recognised territory covering , and encompassing one-ei ...
and
Italy Italy ( it, Italia ), officially the Italian Republic, ) or the Republic of Italy, is a country in Southern Europe. It is located in the middle of the Mediterranean Sea, and its territory largely coincides with the homonymous geographical ...
, Tropicamide, a mydriatic eye drop, is used to some degree as an inexpensive recreational drug. Like other anticholinergics, when taken recreationally, tropicamide acts as a deliriant. When injected intravenously, as is most often the case, the tropicamide may cause problems such as slurred speech, unconsciousness, unresponsiveness, hallucinations, kidney pain, dysphoria, hyperthermia, tremors, suicidal tendency, convulsions, psychomotor agitation, tachycardia and headache.


Injectable medication

Syringe designed saline drops (e.g. Wallace Cameron Ultra Saline Minipod) are distributed in modern
needle-exchange programme A needle and syringe programme (NSP), also known as needle exchange program (NEP), is a social service that allows injecting drug users (IDUs) to obtain clean and unused hypodermic needles and associated paraphernalia at little or no cost. It ...
s as they can be used efficiently either by injection or ophthalmic (if the drug is potent in small doses) route of administer which is compared to intravenous use; by demonstration, the elimination of latanoprost acid from plasma is rapid (half-life 17 minutes) after either ophthalmic or intravenous administration.


Side effects

Steroid and antibiotic eye drops may cause stinging for one or two minutes when first used and if stinging continues, medical advice should be sought. Also, one should tell their doctor if vision changes occur or if they experience persistent
sore throat Sore throat, also known as throat pain, is pain or irritation of the throat. Usually, causes of sore throat include * viral infections * group A streptococcal infection (GAS) bacterial infection * pharyngitis (inflammation of the throat) * to ...
,
fever Fever, also referred to as pyrexia, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using val ...
, easy
bleeding Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ...
or
bruising A bruise, also known as a contusion, is a type of hematoma of tissue, the most common cause being capillaries damaged by trauma, causing localized bleeding that extravasates into the surrounding interstitial tissues. Most bruises occur close ...
when using drops with
chloramphenicol Chloramphenicol is an antibiotic useful for the treatment of a number of bacterial infections. This includes use as an eye ointment to treat conjunctivitis. By mouth or by injection into a vein, it is used to treat meningitis, plague, chole ...
. Also, one should be aware of symptoms of an allergic reaction, such as:
rash A rash is a change of the human skin which affects its color, appearance, or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, c ...
,
itching Itch (also known as pruritus) is a sensation that causes the desire or reflex to scratch. Itch has resisted many attempts to be classified as any one type of sensory experience. Itch has many similarities to pain, and while both are unpleasan ...
, swelling,
dizziness Dizziness is an imprecise term that can refer to a sense of disorientation in space, vertigo, or lightheadedness. It can also refer to disequilibrium or a non-specific feeling, such as giddiness or foolishness. Dizziness is a common medical c ...
, and trouble breathing. Long term steroid use can cause many adverse effects including steroid-induced
glaucoma Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for aqueous humor, fluid withi ...
and cataract. Prostaglandin analogs may cause changes in iris color and eyelid skin, growth of eyelashes, stinging,
blurred vision Blurred vision is an ocular symptom where vision becomes less precise and there is added difficulty to resolve fine details. Temporary blurred vision may involve dry eyes, eye infections, alcohol poisoning, hypoglycemia, or low blood pressure ...
, eye redness, itching, and burning. Beta blockers' side effects include low blood pressure, reduced
pulse rate In medicine, a pulse represents the tactile arterial palpation of the cardiac cycle (heartbeat) by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed near the surface of the body, such as at the ...
,
fatigue Fatigue describes a state of tiredness that does not resolve with rest or sleep. In general usage, fatigue is synonymous with extreme tiredness or exhaustion that normally follows prolonged physical or mental activity. When it does not resolve ...
, shortness of breath, and in rare occasions, reduced
libido Libido (; colloquial: sex drive) is a person's overall sexual drive or desire for sexual activity. Libido is influenced by biological, psychological, and social factors. Biologically, the sex hormones and associated neurotransmitters that act u ...
and depression. Alpha agonists can cause burning or stinging, fatigue,
headache Headache is the symptom of pain in the face, head, or neck. It can occur as a migraine, tension-type headache, or cluster headache. There is an increased risk of depression in those with severe headaches. Headaches can occur as a result ...
, drowsiness, dry mouth and
nose A nose is a protuberance in vertebrates that houses the nostrils, or nares, which receive and expel air for respiration alongside the mouth. Behind the nose are the olfactory mucosa and the sinuses. Behind the nasal cavity, air next passe ...
, and also they have a higher likelihood of allergic reaction. Carbonic anhydrase inhibitors may cause stinging, burning, and eye discomfort. Lubricant eye drops may cause some side effects and one should consult a doctor if pain in the eye or changes in vision occur. Furthermore, when redness occurs but lasts more than 3 days, one should immediately consult a doctor.


See also

* Artificial tears *
Carboxymethyl cellulose Carboxymethyl cellulose (CMC) or cellulose gum is a cellulose derivative with carboxymethyl groups (-CH2-COOH) bound to some of the hydroxyl groups of the glucopyranose monomers that make up the cellulose backbone. It is often used as its sodiu ...
*
Mydriasis Mydriasis is the dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response. Non-physiological causes of mydriasis include disease, trauma, or the use of certain types of drugs. Normally, a ...
*
Refractive error Refractive error, also known as refraction error, is a problem with focusing light accurately on the retina due to the shape of the eye and or cornea. The most common types of refractive error are near-sightedness, far-sightedness, astigmatism ...
* Tetrahydrozoline hydrochloride *
Visine Visine is a brand of eye drops produced by Johnson & Johnson. Johnson & Johnson acquired Visine, along with Pfizer's entire consumer healthcare portfolio, in December 2006. In some countries it is called Vispring. Visine Original The active i ...


References


External links

* * {{DEFAULTSORT:Eye Drop Dosage forms Drug delivery devices Ophthalmology drugs Ophthalmic drug administration