In ophthalmology, numerous drugs are used in the form of eye drops or eye ointments. It should be noted that eye drops are absorbed more quickly and eye ointments often remain in the eye much longer and thus cause the typical deterioration of vision (schlieren vision). In addition to the cortisone and antibiotic eye drops, which are mainly used for bacterial infections and inflammations, the non-steroidal anti-inflammatory drugs and the local anaesthetics, which are mainly used in intraocular pressure examinations, are frequent groups of drugs. In the treatment of glaucoma, numerous eye drops are used, the systematic counterpart of which is mainly used in the cardiovascular therapy of patients.
Antibiotics
Antibiotics can be administered in the form of eye drops or eye ointments. Indications are: The following groups of agents are used with the antibiotics: If severe eye infections occur, antibiotic therapy must be applied systemically. In this case, tablets are used which act on the entire body.
A special form of antibiotic eye drops are the antimycotic eye drops. These are anti-fungal agents which are always used when the cause of an eye disease is seen to be a fungal infection, and this could even be ensured by a smear test of the eye under certain circumstances. – direct bacterial infections of the eye
- As prophylactic measures after operations (to prevent infection)
- After corneal injuries (to prevent infection)
- Aminoglycosides (gentamycin, kanamycin, neomycin, tobramycin) -> act against staphylococci and enterobacteria
- Gyrase inhibitors (ciprofloxacin, ofloxacin) -> act against chlamydia, among others
- Polymycin B -> effective against pseudomonads and other gram-negative rods
The effect of which is either an increase in the outflow of aqueous humor or a reduction in the production of aqueous humor, which leads to a normalization of the intraocular pressure that is easy on the optic nerves.
- Beta-Blocker
- Prostaglandin derivatives
- Alpha-2 agonists
- Carboanhydrase inhibitors
- Cholinergia
- Adrenergics
Reasons to take this group of drugs are: The main diseases for which cortisone-containing eye drops are used are allergic conjunctivitis and inflammation of the middle eye skin (uveitis). In the case of long therapy periods with cortisone-containing medication, it must be noted that the intraocular pressure can increase as a side effect (induced glaucoma). Furthermore, even with long medication, ocular lens clouding (cataract) can occur. – if the immune system of the body and essentially in the area of the eye is to be shut down. – in case of allergic reactions
Eye drops to lower eye pressure
In addition to antibiotic and anti-inflammatory eye drops, ophthalmologists also regularly use drugs that reduce chronically increased intraocular pressure (glaucoma). The reduction of intraocular pressure can be achieved by various drugs: In addition to the above-mentioned groups of drugs used in ophthalmology, drugs in the form of eye drops are increasingly used to wet and moisten the cornea in cases of dry eye syndromes. In contrast to the aforementioned drugs, the so-called tear substitutes have relatively few side effects and can be used generously.
- Beta-blockers (Betaxolol, Timolol, Carteolol, Pindolol) are normally used in internal medicine when the heart rate needs to be lowered in case of heart disease or high blood pressure. As a side effect, beta-blockers also show a decrease in intraocular pressure, and for this reason beta-blocker eye drops are used in glaucoma patients. – Prostaglandin derivatives (Bimatoprost, Latanoprost, Travoprost, Unoprostone) increase the outflow of aqueous humor, which also results in a reduction of intraocular pressure.
- Alpha- 2- agonists (Apraclonidine, Brimonidine, Clondine) reduce the production of aqueous humor and are therefore also used in glaucoma patients. – Carboanhydrase inhibitors are used as the last glaucoma medication. These include brinzolamide and dorzolamide, which reduce the production of aqueous humor.
In most cases, eye drops are applied to the conjunctival sac and the dosage of one drop per eye is chosen. The patient should place the head in the neck and look up while the lower eyelid is pulled down. The eye drops then collect in the conjunctival sac and are distributed on the eye surface when the eye is closed.
The active ingredients are absorbed through the conjunctiva and cornea and unfold their corresponding effect. The remaining eye drops are drained off via the so-called Schlemm canal. In some cases this is perceived by the patient as a bitter taste (especially with glaucoma medication).