Non-Medicated Ophthalmic Ointments

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Questions and Answers

Which over-the-counter medications are recommended over phenylephrine or oxymetazoline for rebound congestion?

Ophthalmic mast cell stabilizers

Naphazoline or tetrahydrozoline (correct)

Sodium chloride solutions

Antihistamines

What is the primary goal of treating corneal edema?

To remove the irritant

To reduce symptoms

To draw fluid from the cornea (correct)

To prevent further damage

What is the first-line treatment for corneal edema?

Medical referral

Instillation of a 2% solution 4 times a day (correct)

Instillation of a 5% solution 4 times a day

Nighttime use of a 5% hyperosmotic ointment

What is the purpose of using a 5% hyperosmotic ointment at night in treating corneal edema?

To enhance the effect of the 2% solution Signup and view all the answers

When should medical referral be necessary for corneal edema?

If symptoms do not respond to the augmented treatment Signup and view all the answers

What is the immediate response of the eye to loose foreign substances?

Watering (tearing) Signup and view all the answers

What is the goal of treating loose foreign substances in the eye?

To remove the irritant Signup and view all the answers

What is a cause of corneal edema?

Over-wear of contact lenses Signup and view all the answers

What is the primary advantage of non-medicated ointments?

To enhance the integrity of the tear film Signup and view all the answers

What is the purpose of lanolin in non-medicated ophthalmic ointments?

To facilitate incorporation of water-soluble medications Signup and view all the answers

Why do some patients prefer to instill ointments at bedtime?

To keep the eyes moist during sleep and improve morning symptoms of dry eye Signup and view all the answers

What is a common side effect of using ointments in the eye?

Blurred vision Signup and view all the answers

What percentage of white petrolatum is typically found in commercial non-prescription ophthalmic ointments?

60% Signup and view all the answers

What is the purpose of mineral oil in non-medicated ophthalmic ointments?

To help the ointment melt at body temperature Signup and view all the answers

How often may ointments be administered, depending on the patient's clinical needs and therapeutic response?

Every few hours or only occasionally, as needed Signup and view all the answers

Why is it essential for providers to counsel patients about ointments?

To advise them about potential blurred vision Signup and view all the answers

What is the primary goal of treating dry eye disease?

To alleviate and control the dryness of the ocular surface Signup and view all the answers

What is the primary self-treatment for dry eye disease?

Use of ocular lubricants Signup and view all the answers

What determines the viscosity of artificial tear products?

The type of ingredients used in their preparation Signup and view all the answers

When are ointment preparations typically used to treat dry eye disease?

At bedtime or for severe cases of dry eye Signup and view all the answers

What is the advantage of using more viscous artificial tear products?

They have a greater resistance to tear dilution Signup and view all the answers

What is the primary nondrug measure for treating dry eye disease?

Avoiding environments that increase evaporation of the tear film Signup and view all the answers

What type of preparation is available for treating dry eye disease?

Vitamin A preparation Signup and view all the answers

Why are more viscous ointments not typically used during the day?

They cause blurred vision Signup and view all the answers

The primary goal of treating dry eye disease is to eliminate the symptoms of irritation and prevent possible tissue and corneal damage.

True Signup and view all the answers

The term 'dry eye disease' is not a commonly accepted term for this condition.

False Signup and view all the answers

Ocular lubricants are not typically used to treat dry eye disease.

False Signup and view all the answers

Increasing the viscosity of an artificial tear product results in a shorter ocular contact time.

False Signup and view all the answers

Vitamin A preparations are not available for treating dry eye disease.

False Signup and view all the answers

The primary nondrug measure for treating dry eye disease is to increase the evaporation of the tear film.

False Signup and view all the answers

Bland ophthalmic ointments are typically used during the day to treat dry eye disease.

False Signup and view all the answers

The viscosity of artificial tear products is determined by the patient's clinical needs and therapeutic response.

False Signup and view all the answers

Using humidifiers may help alleviate dry eye problems.

True Signup and view all the answers

Artificial tear solutions consist of only preservatives and inorganic electrolytes.

False Signup and view all the answers

Prolonged use of computer screens can help alleviate dry eye problems.

False Signup and view all the answers

Wearing eye protection in windy, outdoor environments can help alleviate dry eye problems.

True Signup and view all the answers

The newer artificial tear substitutes do not have the ability to stabilize the tear film.

False Signup and view all the answers

Repositioning workstations away from heating and air conditioning vents can help alleviate dry eye problems.

True Signup and view all the answers

Sorbic acid is used as a preservative in some artificial tear solutions.

True Signup and view all the answers

Hydroxypropyl methylcellulose is a common component in non-medicated gels.

True Signup and view all the answers

PVA is compatible with all commonly used drugs and preservatives.

False Signup and view all the answers

Boric acid is used as a preservative in some artificial tear solutions.

True Signup and view all the answers

Sodium chloride is not used in artificial tear solutions.

False Signup and view all the answers

Carbopol 980 is a component in some artificial tear solutions.

True Signup and view all the answers

PVA is typically used in non-medicated gels.

False Signup and view all the answers

EDTA is used as a preservative in some artificial tear solutions.

True Signup and view all the answers

What is the purpose of EDTA in artificial tear solutions?

EDTA is used as a preservative in some artificial tear solutions. Signup and view all the answers

Which component is responsible for thickening or gelling solutions containing PVA?

Certain compounds, such as sodium bicarbonate, sodium borate, the sulfates of sodium, potassium, and zinc, can thicken or gel solutions containing PVA. Signup and view all the answers

What is the purpose of hydroxypropyl methylcellulose in artificial tear solutions?

Hydroxypropyl methylcellulose is a common component in artificial tear solutions, serving as a lubricant and helping to maintain moisture in the eye. Signup and view all the answers

What is the purpose of boric acid in some artificial tear solutions?

Boric acid is used as a preservative in some artificial tear solutions. Signup and view all the answers

What is the role of sodium chloride in artificial tear solutions?

Sodium chloride is used in artificial tear solutions to help maintain the natural balance of electrolytes in the tear film. Signup and view all the answers

What is the purpose of PVA in artificial tear solutions?

PVA is a component in artificial tear solutions that serves as a lubricant and helps to maintain moisture in the eye. Signup and view all the answers

What is the purpose of carbopol 980 in some artificial tear solutions?

Carbopol 980 is a component in some artificial tear solutions, serving as a thickening agent and helping to maintain the solution's viscosity. Signup and view all the answers

What is the purpose of sorbic acid in some artificial tear solutions?

Sorbic acid is used as a preservative in some artificial tear solutions. Signup and view all the answers

What environmental adjustments can patients make to alleviate dry eye problems?

Using humidifiers, repositioning workstations away from heating and air conditioning vents, and avoiding dry or dusty places Signup and view all the answers

What are the benefits of newer artificial tear substitutes?

Stabilizing the tear film, protecting the corneal and conjunctival cells, reducing tear evaporation, and enhancing wound healing and lubrication of the ocular surface Signup and view all the answers

What are some common components of artificial tear solutions?

Preservatives, inorganic electrolytes, and water-soluble polymeric systems Signup and view all the answers

What activities can exacerbate dry eye problems?

Prolonged use of computer screens and exposure to windy, outdoor environments Signup and view all the answers

What is the primary goal of treating dry eye disease?

To eliminate the symptoms of irritation and prevent possible tissue and corneal damage Signup and view all the answers

What are some non-pharmacologic measures that can help alleviate dry eye problems?

Using humidifiers, repositioning workstations, avoiding prolonged computer use, and wearing eye protection in windy environments Signup and view all the answers

What is the primary goal of treating dry eye disease?

To alleviate and control the dryness of the ocular surface, thereby relieving the symptoms of irritation and preventing possible tissue and corneal damage. Signup and view all the answers

What is the primary self-treatment for dry eye disease?

The use of ocular lubricants. Signup and view all the answers

What determines the viscosity of artificial tear products?

The ingredients used in their preparation. Signup and view all the answers

When are ointment preparations typically used to treat dry eye disease?

At bedtime or for severe cases of dry eye. Signup and view all the answers

What is the advantage of using more viscous artificial tear products?

They have a more prolonged ocular contact time and greater resistance to tear dilution. Signup and view all the answers

What is the primary nondrug measure for treating dry eye disease?

Avoiding environments that increase evaporation of the tear film. Signup and view all the answers

What type of preparation is available for treating dry eye disease?

Vitamin A preparations. Signup and view all the answers

Why are more viscous ointments not typically used during the day?

They cause blurred vision. Signup and view all the answers

What is the primary purpose of PVA in artificial tear solutions?

To provide lubrication and moisture to the eye Signup and view all the answers

What is the effect of certain compounds, such as sodium bicarbonate, on PVA solutions?

They can thicken or gel the solutions Signup and view all the answers

What is the purpose of EDTA in artificial tear solutions?

To act as a preservative Signup and view all the answers

What are some common allergens that can cause ocular allergy?

Pollen, animal dander, and topical eye preparations Signup and view all the answers

What is the function of hydroxypropyl methylcellulose in artificial tear solutions?

To provide lubrication and moisture to the eye Signup and view all the answers

What is the purpose of boric acid in some artificial tear solutions?

To act as a preservative or to help maintain the pH of the solution Signup and view all the answers

What is the hallmark symptom of ocular allergy?

Itching Signup and view all the answers

What are the general treatment goals for allergic conjunctivitis?

Remove or avoid the allergen, limit or reduce the severity of the allergic reaction, provide symptomatic relief, and protect the ocular surface Signup and view all the answers

What is sorbic acid used for in artificial tear solutions?

As a preservative Signup and view all the answers

What is the purpose of carbopol 980 in some artificial tear solutions?

To help thicken or gel the solution Signup and view all the answers

What is a non-pharmacologic therapy for allergic conjunctivitis?

Applying cold compresses to the eyes Signup and view all the answers

What is the primary importance of controlling the pH of ophthalmic products?

To ensure patient comfort and adherence to self-treatment Signup and view all the answers

What is the primary advantage of using non-medicated gels?

They are gentle and non-irritating, making them suitable for sensitive eyes Signup and view all the answers

What is the role of buffers in ophthalmic products?

To maintain the pH of the product Signup and view all the answers

Why are drug vehicle and preservative systems important in ophthalmic products?

They are among the most important inactive ingredients and contribute to patient comfort and adherence to self-treatment Signup and view all the answers

What should be avoided in patients with allergic conjunctivitis?

Using contact lenses until the condition resolves Signup and view all the answers

What is the primary concern if a foreign substance is a fragment of wood or metal?

Penetrating injuries Signup and view all the answers

What is the purpose of ocular irrigants?

To clear away unwanted materials or debris from the ocular surface Signup and view all the answers

When should patients use ocular irrigants with caution?

When they have open wounds in or near the eyes or other ocular pathology Signup and view all the answers

What is a sign that a patient needs to evaluate their eye condition with an eye care provider?

Continuous eye pain, changes in vision, or continued redness or irritation of the eye Signup and view all the answers

What is the risk of using an eyecup to rinse the eye?

Contamination Signup and view all the answers

What is the primary goal of treating foreign substances in the eye?

To remove the substance Signup and view all the answers

What type of materials can usually be removed by rinsing the eye with sterile saline or specific eyewash preparations?

Lint, dust, and similar materials Signup and view all the answers

When can eye ointment be applied?

At bedtime, if needed Signup and view all the answers

What is the primary goal of treating dry eye disease?

To alleviate and control the dryness of the ocular surface, thereby relieving the symptoms of irritation and preventing possible tissue and corneal damage. Signup and view all the answers

What is the primary self-treatment for dry eye disease?

The use of ocular lubricants. Signup and view all the answers

What determines the viscosity of artificial tear products?

The ingredients used in their preparation. Signup and view all the answers

When are ointment preparations typically used to treat dry eye disease?

At bedtime or for severe cases of dry eye. Signup and view all the answers

What is the advantage of using more viscous artificial tear products?

They have a more prolonged ocular contact time and greater resistance to tear dilution. Signup and view all the answers

What is the primary nondrug measure for treating dry eye disease?

Avoiding environments that increase evaporation of the tear film. Signup and view all the answers

What type of preparation is available for treating dry eye disease?

Vitamin A preparations. Signup and view all the answers

Why are more viscous ointments not typically used during the day?

They cause blurred vision. Signup and view all the answers

What is a common sign of minor eye irritation?

Redness of the eye Signup and view all the answers

What is the recommended dosage of zinc sulfate for temporary relief of minor ocular irritation?

1-2 drops up to 4 times daily Signup and view all the answers

What are the common causes of chemical burns?

Alkali, acids, detergents, and various solvents and irritants Signup and view all the answers

What is a characteristic of alkali burns compared to acid burns?

Alkali burns are more penetrating and potentially more damaging to eye tissues Signup and view all the answers

What is a common symptom of minor eye irritation, besides redness?

Pain and the feeling of 'sand in the eyes' Signup and view all the answers

What is the purpose of artificial tear solutions or non-medicated ointments in treating minor eye irritation?

To provide relief Signup and view all the answers

What is a severe sign of chemical burn?

Corneal edema and opacification, anterior chamber inflammation, increased IOP, and retinal toxicity from scleral penetration Signup and view all the answers

What is a characteristic of less severe signs of chemical burn?

Superficial punctate keratitis, perilimbal ischemia, chemosis, hyperemia, eyelid edema, hemorrhages, and first or second degree burns of the lid and outer skin Signup and view all the answers

Patients should avoid dry or ______ places to alleviate dry eye problems.

dusty Signup and view all the answers

Using humidifiers may help alleviate dry eye problems by adding ______ to the air.

moisture Signup and view all the answers

Artificial tear solutions consist of preservatives, inorganic electrolytes to achieve ______ and maintain pH.

tonicity Signup and view all the answers

The newer artificial tear substitutes have the ability to ______ the tear film and protect the corneal and conjunctival cells.

stabilize Signup and view all the answers

Repositioning workstations away from ______ and air conditioning vents may help alleviate dry eye problems.

heating Signup and view all the answers

Wearing eye protection in ______ outdoor environments may further help alleviate dry eye problems.

windy Signup and view all the answers

The primary goal of treating dry eye disease is to alleviate and control the ______ of the ocular surface.

dryness Signup and view all the answers

The term 'dry eye disease' is accepted by the ______ International Dry Eye Workshop.

International Signup and view all the answers

Artificial tears help alleviate ______ of the ocular surface.

dryness Signup and view all the answers

The primary self-treatment for dry eye disease is the use of ______ lubricants.

ocular Signup and view all the answers

______ tear products vary by viscosity according to the ingredients used in their preparation.

Artificial Signup and view all the answers

Bland ophthalmic ______ is another type of ocular lubricant.

ointment Signup and view all the answers

The primary nondrug measure for treating dry eye disease is avoiding environments that increase ______ of the tear film.

evaporation Signup and view all the answers

Vitamin A ______ are also available for treating dry eye disease.

preparations Signup and view all the answers

PVA is compatible with many commonly used drugs and preservatives, but certain compounds such as ______ can thicken or gel solutions containing PVA.

sodium bicarbonate Signup and view all the answers

______ is a component in some artificial tear solutions and is used as a preservative.

Sorbic acid Signup and view all the answers

Hydroxypropyl methylcellulose is a common component in non-medicated ______.

gels Signup and view all the answers

PVA is typically used in ______ gels.

non-medicated Signup and view all the answers

______ is used as a preservative in some artificial tear solutions.

EDTA Signup and view all the answers

______ is used as a component in some artificial tear solutions and acts as a thickening agent.

Carbopol 980 Signup and view all the answers

Hydroxypropyl methylcellulose is a component in some artificial tear solutions and is used as a ______.

lubricant Signup and view all the answers

______ is a component in some artificial tear solutions and is used as a preservative.

Boric acid Signup and view all the answers

Match the following components with their uses in artificial tear solutions:

Hydroxypropyl methylcellulose = Thickening agent Boric acid = Preservative EDTA = Chelating agent PVA = Viscosity enhancer Signup and view all the answers

Match the following components with their functions in lubricant solutions:

Sorbic acid = Preservative Carbopol 980 = Thickening agent Glycerin = Humectant PEG-400 = Viscosity enhancer Signup and view all the answers

Match the following components with their incompatibilities in artificial tear solutions:

PVA = Sodium borate Sodium chloride = EDTA Glycerin = Boric acid Hydroxypropyl methylcellulose = Sorbic acid Signup and view all the answers

Match the following lubricant solutions with their characteristics:

Non-medicated gels = Viscous and transparent Artificial tear solutions = Less viscous and transparent Ointments = Thick and non-transparent Hydroxypropyl methylcellulose = Viscous and non-transparent Signup and view all the answers

Match the following components with their effects on PVA in artificial tear solutions:

Sodium bicarbonate = Thickening Sodium borate = Gelling EDTA = Chelating PVA = Viscosity enhancement Signup and view all the answers

Match the following components with their roles in ophthalmic lubricants:

CMC = Thickening agent PEG = Viscosity enhancer KCl = Electrolyte NaCl = Osmolality regulator Signup and view all the answers

Match the following components with their functions in artificial tear solutions:

Propylene glycol = Humectant Sodium phosphate = pH buffer Polyquaternium preservative = Preservative Hydroxypropyl guar = Thickening agent Signup and view all the answers

Match the following components with their uses in ophthalmic lubricants:

Boric acid = Antimicrobial agent Sorbic acid = Preservative Calcium chloride = Electrolyte Zinc chloride = Antimicrobial agent Signup and view all the answers

Match the following methods with their potential benefits in alleviating dry eye problems:

Using humidifiers = Reduce evaporation of the tear film Avoiding prolonged use of computer screens = Reduce dryness caused by screen time Wearing eye protection in windy environments = Protect the eyes from wind and dust Repositioning workstations away from heating vents = Reduce dry air from heating systems Signup and view all the answers

Match the following components of artificial tear solutions with their functions:

Preservatives = Prevent bacterial growth and contamination Inorganic electrolytes = Maintain pH and tonicity Water soluble polymeric systems = Provide lubrication and moisture Lipids = Stabilize the tear film and reduce evaporation Signup and view all the answers

Match the following benefits of newer artificial tear substitutes with their effects:

Stabilize the tear film = Prevent tear film break-up Protect the corneal and conjunctival cells = Reduce inflammation and damage Reduce tear evaporation = Prevent dryness and irritation Enhance wound healing = Promote recovery from eye injuries Signup and view all the answers

Match the following measures with their effects on dry eye disease:

Avoiding dry or dusty places = Reduce exposure to dry air Prolonged use of computer screens = Increase dryness and irritation Wearing eye protection in windy environments = Reduce wind and dust exposure Repositioning workstations away from heating vents = Reduce dry air from heating systems Signup and view all the answers

Match the following components of artificial tear solutions with their roles:

Buffering agents = Maintain pH levels Preservatives = Prevent contamination and bacterial growth pH regulators = Adjust pH levels to match the eye Lubricating agents = Provide moisture and smoothness Signup and view all the answers

Match the following characteristics of artificial tear solutions with their benefits:

Water soluble polymeric systems = Provide lubrication and moisture Lipids = Stabilize the tear film and reduce evaporation Inorganic electrolytes = Maintain pH and tonicity Preservatives = Prevent contamination and bacterial growth Signup and view all the answers

Match the following terms with their descriptions:

Dry eye disease = A term used to describe the dryness of the ocular surface Kerato-conjunctivitis sicca = Another term used to describe dry eye disease Dysfunctional tear syndrome = A synonym for dry eye disease Artificial tears = Ocular lubricants used to alleviate dryness Signup and view all the answers

Match the following ocular lubricants with their characteristics:

Artificial tears = May have varying viscosity depending on ingredients Ointments = Typically reserved for bedtime or severe cases of dry eye Vitamin A preparations = Used to treat dry eye disease Bland ophthalmic ointment = Contains petrolatum Signup and view all the answers

Match the following treatments with their purposes:

Systemic omega-3 fatty acid supplements = Used to treat mild and moderate dry eye disease Environmental modifications = Part of non-pharmacologic treatment for dry eye disease Eyelid therapy = Part of pharmacologic treatment for dry eye disease Education = Part of self-treatment for dry eye disease Signup and view all the answers

Match the following characteristics with their effects:

Viscous artificial tears = Prolonged ocular contact time and greater resistance to tear dilution Less viscous artificial tears = Shorter ocular contact time and less resistance to tear dilution More viscous ointments = Greater blurring effect Less viscous ointments = Less blurring effect Signup and view all the answers

Match the following nondrug measures with their purposes:

Avoiding environments that increase evaporation of the tear film = Primary nondrug measure for treating dry eye disease Using humidifiers = May help alleviate dry eye problems Wearing eye protection = May help alleviate dry eye problems Repositioning workstations = May help alleviate dry eye problems Signup and view all the answers

Match the following artificial tear products with their components:

Non-medicated gels = May contain hydroxypropyl methylcellulose Some artificial tear solutions = May contain sorbic acid as a preservative Signup and view all the answers

Match the following types of lubricants with their uses:

Artificial tears = Used to alleviate dryness of the ocular surface Ointments = Typically used at bedtime or for severe cases of dry eye Vitamin A preparations = Used to treat dry eye disease Bland ophthalmic ointment = Used to treat dry eye disease Signup and view all the answers

Match the following characteristics with their effects on artificial tears:

Increasing viscosity = Prolonged ocular contact time and greater resistance to tear dilution Decreasing viscosity = Shorter ocular contact time and less resistance to tear dilution Using more viscous products = Greater blurring effect Using less viscous products = Less blurring effect Signup and view all the answers

Study Notes

Non-Medicated Ophthalmic Ointments

Primary ingredients: 60% white petrolatum (lubricant and ointment base), 40% mineral oil (melts at body temperature), and lanolin (facilitates water-soluble medication incorporation and prevents evaporation)
Advantages: enhanced retention time, improves tear film integrity, and benefits mucin and aqueous deficient eyes
Administration: usually twice daily, but can be adjusted based on patient needs and response

Administration Guidelines

Patients may experience blurred vision due to the viscosity of the melted ointment base
Blurred vision can be managed by decreasing the amount of ointment instilled or administering at bedtime

Formulation Considerations for Ocular Lubricants

Ocular lubricants are formulated to reduce stinging, burning, and other side effects associated with ophthalmic drugs
Naphazoline or tetrahydrozoline are recommended over phenylephrine or oxymetazoline due to less likelihood of rebound congestion

Corneal Edema

Causes: over-wear of contact lenses, surgical damage to the cornea, and inherited corneal dystrophies
Treatment goal: to draw fluid from the cornea, relieving associated symptoms

Treatment of Corneal Edema

Topical hyperosmotic formulations: sodium chloride (2% or 5% solution, 5% ointment) is available over-the-counter
First-line treatment: 2% solution instilled 4 times per day; if symptoms persist, add 5% hyperosmotic ointment at night

Loose Foreign Substances in the Eye

Treatment goal: to remove the irritant by irrigating the eye
Self-treatment is appropriate if the substance causes minor irritation and does not abrade the eye surface

Treatment of Dry Eye Disease

Goal: to alleviate and control dryness of the ocular surface, relieving symptoms of irritation and preventing tissue damage
Primary self-treatment: use of ocular lubricants
Other treatment approaches:
- Education
- Environmental modifications
- Eyelid therapy
- Elimination of offending topical or systemic medications
- Use of systemic omega-3 fatty acid supplements (e.g., flax seed oil)

Artificial Tears

Help alleviate dryness of the ocular surface
Product viscosity affects ocular contact time and resistance to tear dilution
Mild cases: less viscous products; severe cases: more viscous products

Nonpharmacologic Therapy

Primary measure: avoiding environments that increase evaporation of the tear film

Managing Dry Eye

Patients should avoid dry or dusty places to alleviate dry eye problems.
Using humidifiers or repositioning workstations away from heating and air conditioning vents can help alleviate dry eyes.
Avoiding prolonged use of computer screens and wearing eye protection (e.g., sunglasses or goggles) in windy, outdoor environments can further help alleviate dry eye problems.

Pharmacologic Therapy

Artificial tear solutions consist of preservatives, inorganic electrolytes, and water-soluble polymeric systems.
Newer artificial tear substitutes have properties that stabilize the tear film, protect the corneal and conjunctival cells, reduce tear evaporation, and enhance wound healing and lubrication of the ocular surface.

Components of Nonprescription Ophthalmic Lubricants

Artificial tear solutions:
- Hydroxypropyl methylcellulose 0.3%
- Dextran 70, 0.1%
- Sorbic acid 0.25%
- EDTA 0.1%
- NaCl
- Hypromellose
- Glycerin
Non-medicated gels:
- Hydroxypropyl methylcellulose 0.3%
- Sodium perborate 0.028%
- Carbopol 980
- Phosphoric acid
- Sorbitol

PVA Compatibility

PVA is compatible with many commonly used drugs and preservatives.
However, certain compounds (e.g., sodium bicarbonate, sodium borate, the sulfates of sodium, potassium, and zinc) can thicken or gel solutions containing PVA.

Treatment of Dry Eye Disease

The goal of treating dry eye disease is to alleviate and control the dryness of the ocular surface, relieving symptoms of irritation and preventing tissue and corneal damage.
Dry eye disease has also been referred to as “dysfunctional tear syndrome,” “kerato-conjunctivitis sicca,” and “dry eye disease.”

General Treatment Approach

The primary self-treatment for dry eye disease is the use of ocular lubricants.
Treatment of mild and moderate dry eye disease also includes education, environmental modifications, eyelid therapy, elimination of offending topical or systemic medications, and use of systemic omega-3 fatty acid supplements.
Artificial tears help alleviate dryness of the ocular surface.
Artificial tear products vary by viscosity according to the ingredients used in their preparation.
Increasing the viscosity of a product results in a more prolonged ocular contact time and greater resistance to tear dilution.

Nonpharmacologic Therapy

The primary non-drug measure is avoiding environments that increase evaporation of the tear film.

Managing Dry Eye

Patients should avoid dry or dusty places to alleviate dry eye problems.
Using humidifiers or repositioning workstations away from heating and air conditioning vents can help alleviate dry eyes.
Avoiding prolonged use of computer screens and wearing eye protection (e.g., sunglasses or goggles) in windy, outdoor environments can further help alleviate dry eye problems.

Pharmacologic Therapy

Artificial tear solutions consist of preservatives, inorganic electrolytes, and water-soluble polymeric systems.
Newer artificial tear substitutes have properties that stabilize the tear film, protect the corneal and conjunctival cells, reduce tear evaporation, and enhance wound healing and lubrication of the ocular surface.

Components of Nonprescription Ophthalmic Lubricants

Artificial tear solutions:
- Hydroxypropyl methylcellulose 0.3%
- Dextran 70, 0.1%
- Sorbic acid 0.25%
- EDTA 0.1%
- NaCl
- Hypromellose
- Glycerin
Non-medicated gels:
- Hydroxypropyl methylcellulose 0.3%
- Sodium perborate 0.028%
- Carbopol 980
- Phosphoric acid
- Sorbitol

PVA Compatibility

PVA is compatible with many commonly used drugs and preservatives.
However, certain compounds (e.g., sodium bicarbonate, sodium borate, the sulfates of sodium, potassium, and zinc) can thicken or gel solutions containing PVA.

Treatment of Dry Eye Disease

The goal of treating dry eye disease is to alleviate and control the dryness of the ocular surface, relieving symptoms of irritation and preventing tissue and corneal damage.
Dry eye disease has also been referred to as “dysfunctional tear syndrome,” “kerato-conjunctivitis sicca,” and “dry eye disease.”

General Treatment Approach

The primary self-treatment for dry eye disease is the use of ocular lubricants.
Treatment of mild and moderate dry eye disease also includes education, environmental modifications, eyelid therapy, elimination of offending topical or systemic medications, and use of systemic omega-3 fatty acid supplements.
Artificial tears help alleviate dryness of the ocular surface.
Artificial tear products vary by viscosity according to the ingredients used in their preparation.
Increasing the viscosity of a product results in a more prolonged ocular contact time and greater resistance to tear dilution.

Nonpharmacologic Therapy

The primary non-drug measure is avoiding environments that increase evaporation of the tear film.

Treatment of Dry Eye Disease

The primary goal of treating dry eye disease is to alleviate and control the dryness of the ocular surface, relieving symptoms of irritation and preventing tissue and corneal damage.
The International Dry Eye Workshop (DEWS) accepts "dry eye disease" as the most appropriate term for the condition.
General treatment approaches include:
- Using ocular lubricants, such as artificial tears, to help alleviate dryness of the ocular surface.
- Artificial tear products vary in viscosity, with more viscous products providing longer ocular contact time and greater resistance to tear dilution.
- Mild cases of dry eye disease may be treated with less viscous products, while more severe cases may require more viscous products.
- Bland ophthalmic ointments, such as petrolatum, can be used to help alleviate dryness, but may cause blurred vision.
- Vitamin A preparations are also available for treating dry eye disease.

Nonpharmacologic Therapy

The primary non-drug measure is avoiding environments that increase evaporation of the tear film.
Avoiding dry air, wind, and smoke can help reduce dryness of the ocular surface.

Components of Nonprescription Ophthalmic Lubricants

Artificial tear solutions may contain various ingredients, such as hydroxypropyl methylcellulose, dextran, sorbic acid, and EDTA.
Non-medicated gels may contain ingredients like hydroxypropyl methylcellulose, carbopol, and phosphoric acid.
PVA (polyvinyl alcohol) is a common ingredient in ophthalmic lubricants, but can interact with certain compounds, such as sodium bicarbonate, sodium borate, and sulfates.

Allergic Conjunctivitis

Allergic conjunctivitis is characterized by a red eye with watery discharge, and the hallmark symptom is itching.
Vision is usually not impaired, but may be blurred due to excessive tearing.
Contact lenses should not be used until the condition resolves.
Treatment goals include removing or avoiding the allergen, limiting or reducing the severity of the allergic reaction, providing symptomatic relief, and protecting the ocular surface.

Treatment of Allergic Conjunctivitis

Questioning the patient about exposure to allergens may help identify the offending substance.
Removal or avoidance of the responsible allergen is the best treatment, but non-prescription ocular lubricants, ocular decongestants, and ocular antihistamines can also help relieve symptoms.
Applying cold compresses to the eyes 3-4 times per day can help reduce redness and itching.

Pharmacologic Therapy

Ocular irrigants are used to cleanse ocular tissues while maintaining their moisture, and must be physiologically balanced with respect to pH and osmolality.
Ocular irrigants should not be used for open wounds in or near the eyes, and should only be used on a short-term basis.

Minor Eye Irritation

Minor eye irritation can be caused by a loose foreign substance in the eye, contact lens wear, or exposure to wind, sun, smog, chemical fumes, or chlorine.
Redness of the eye is a common sign of minor irritation.
Treatment often responds well to artificial tear solutions or non-medicated ointments.

Chemical Burn

Chemical burns can occur from exposure to alkali, acids, detergents, and various solvents and irritants.
Burns may range from mild to severe, depending on the inciting agent and/or exposure time.
Patients complain of pain, irritation, photophobia, and tearing.
Less severe signs include superficial punctate keratitis, perilimbal ischemia, chemosis, hyperemia, eyelid edema, hemorrhages, and first or second degree burns of the lid and outer skin.
More severe signs include corneal edema and opacification, anterior chamber inflammation, increased IOP, and retinal toxicity from scleral penetration.

Managing Dry Eye

Patients should avoid dry or dusty places to alleviate dry eye problems.
Using humidifiers or repositioning workstations away from heating and air conditioning vents can help alleviate dry eyes.
Avoiding prolonged use of computer screens and wearing eye protection (e.g., sunglasses or goggles) in windy, outdoor environments can further help alleviate dry eye problems.

Pharmacologic Therapy

Artificial tear solutions consist of preservatives, inorganic electrolytes, and water-soluble polymeric systems.
Newer artificial tear substitutes have properties that stabilize the tear film, protect the corneal and conjunctival cells, reduce tear evaporation, and enhance wound healing and lubrication of the ocular surface.

Components of Nonprescription Ophthalmic Lubricants

Artificial tear solutions:
- Hydroxypropyl methylcellulose 0.3%
- Dextran 70, 0.1%
- Sorbic acid 0.25%
- EDTA 0.1%
- NaCl
- Hypromellose
- Glycerin
Non-medicated gels:
- Hydroxypropyl methylcellulose 0.3%
- Sodium perborate 0.028%
- Carbopol 980
- Phosphoric acid
- Sorbitol

PVA Compatibility

PVA is compatible with many commonly used drugs and preservatives.
However, certain compounds (e.g., sodium bicarbonate, sodium borate, the sulfates of sodium, potassium, and zinc) can thicken or gel solutions containing PVA.

Treatment of Dry Eye Disease

The goal of treating dry eye disease is to alleviate and control the dryness of the ocular surface, relieving symptoms of irritation and preventing tissue and corneal damage.
Dry eye disease has also been referred to as “dysfunctional tear syndrome,” “kerato-conjunctivitis sicca,” and “dry eye disease.”

General Treatment Approach

The primary self-treatment for dry eye disease is the use of ocular lubricants.
Treatment of mild and moderate dry eye disease also includes education, environmental modifications, eyelid therapy, elimination of offending topical or systemic medications, and use of systemic omega-3 fatty acid supplements.
Artificial tears help alleviate dryness of the ocular surface.
Artificial tear products vary by viscosity according to the ingredients used in their preparation.
Increasing the viscosity of a product results in a more prolonged ocular contact time and greater resistance to tear dilution.

Nonpharmacologic Therapy

The primary non-drug measure is avoiding environments that increase evaporation of the tear film.

Managing Dry Eye

Patients should avoid dry or dusty places to alleviate dry eye problems.
Using humidifiers or repositioning workstations away from heating and air conditioning vents can help alleviate dry eyes.
Avoiding prolonged use of computer screens and wearing eye protection (e.g., sunglasses or goggles) in windy, outdoor environments can further help alleviate dry eye problems.

Pharmacologic Therapy

Artificial tear solutions consist of preservatives, inorganic electrolytes, and water-soluble polymeric systems.
Newer artificial tear substitutes have properties that stabilize the tear film, protect the corneal and conjunctival cells, reduce tear evaporation, and enhance wound healing and lubrication of the ocular surface.

Components of Nonprescription Ophthalmic Lubricants

Artificial tear solutions:
- Hydroxypropyl methylcellulose 0.3%
- Dextran 70, 0.1%
- Sorbic acid 0.25%
- EDTA 0.1%
- NaCl
- Hypromellose
- Glycerin
Non-medicated gels:
- Hydroxypropyl methylcellulose 0.3%
- Sodium perborate 0.028%
- Carbopol 980
- Phosphoric acid
- Sorbitol

PVA Compatibility

PVA is compatible with many commonly used drugs and preservatives.
However, certain compounds (e.g., sodium bicarbonate, sodium borate, the sulfates of sodium, potassium, and zinc) can thicken or gel solutions containing PVA.

Treatment of Dry Eye Disease

The goal of treating dry eye disease is to alleviate and control the dryness of the ocular surface, relieving symptoms of irritation and preventing tissue and corneal damage.
Dry eye disease has also been referred to as “dysfunctional tear syndrome,” “kerato-conjunctivitis sicca,” and “dry eye disease.”

General Treatment Approach

The primary self-treatment for dry eye disease is the use of ocular lubricants.
Treatment of mild and moderate dry eye disease also includes education, environmental modifications, eyelid therapy, elimination of offending topical or systemic medications, and use of systemic omega-3 fatty acid supplements.
Artificial tears help alleviate dryness of the ocular surface.
Artificial tear products vary by viscosity according to the ingredients used in their preparation.
Increasing the viscosity of a product results in a more prolonged ocular contact time and greater resistance to tear dilution.

Nonpharmacologic Therapy

The primary non-drug measure is avoiding environments that increase evaporation of the tear film.

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A quiz about the primary ingredients, advantages, and administration guidelines of non-medicated ophthalmic ointments. Learn about the benefits of these ointments for mucin and aqueous deficient eyes. Effective administration for patients is also covered.