An ointment-based drug preparation manufactured for local application to the eye is called eye ointment. Ointments are often based on anhydrous substances such as vaseline or paraffin and, depending on the indication, active ingredients such as corticosteroids (cortisone), antibiotics or vitamins are then added. Due to the possibility to process different active substances in them, eye ointments represent a therapy option for many disease patterns in ophthalmology.
In the meantime, however, many medications are also available in the form of eye drops. The difference is mainly in the processing. Ointments are fat-based, drops on the other hand are water-based. Accordingly, ointments dissolve less easily and remain in the eye longer, which may support the therapy.
Advantage over eye drops
In contrast to eye drops, eye ointments are much more viscous (tougher) and therefore do not flow out of the eye as quickly as eye drops. Due to this property, they remain in the eye for a longer time and can therefore work better than eye drops or even the eye gels themselves, which are already somewhat thicker in consistency than eye drops. Especially at night an application of eye ointments is much more useful and effective than the use of eye drops or eye gels and a sufficiently long exposure time can be achieved by applying the ointment over night.
Disadvantage compared to eye drops
Probably the biggest disadvantage is that vision is impaired when eye ointments are applied. One can then see as if through streaks, as the viscous ointment “pushes” itself between the eye and the outside world and obscures the view through its consistency. It is precisely for this reason that it is recommended to apply the ointments only directly before going to bed, which makes the disadvantage of impaired vision insignificant.
Indication for eye ointments
- Allergic reaction
- Bacterial inflammation of the eye
- Eye injuries
- Dry eyes (so-called keratoconjunctivitis sicca)
When must eye ointments not be used? In general, eye ointments must not be used on unconscious patients or after accidents, as they could interfere with a neurological assessment or possible surgical measures by the ophthalmologist. Eye ointments should also not be used if the eyeball itself is injured (e.g. piercing). Glaucoma (increased intraocular pressure) is also often a contraindication for many medical eye ointments.
In order to use the eye ointment correctly, it is inserted as an approximately 0.5 cm long strip of ointment into the conjunctival sac with the lower lid slightly pulled down with the finger. It is important to ensure that the tip of the ointment tube does not touch the patient’s eyelashes or conjunctiva, so that contamination of the remaining contents of the ointment tube can be avoided. After application, the eyes should be closed.
Any excess eye ointment which then emerges from the eyes can then be carefully wiped off with a lint-free cloth or compress. The ointment is best applied in a supine position or with the head tilted back. The lower eyelid is gently pulled down with one hand, creating a kind of pocket or wrinkle.
The other hand holding the ointment tube is best supported on the patient’s forehead and can now drop about 0.5 cm of ointment into the fold of the lower eyelid. It is important here that the tube itself does not touch the eye or the eyelashes, so that neither injuries to the eyeball nor the transfer of germs from the eye to the tube can occur. It is easiest to have this done by another person (doctor, parent with children, etc.). After the application, the patient may experience blurred vision due to the so-called ointment film. As a result, the ability to drive is reduced and one should refrain from driving machines of any kind.