Abrasion corneal

These drugp are contraindicated in patients with known hypersensitivity to die drugs, asthma, peptic ulcer disease, coronary artery disease, and hyperthyroidism. Bethanecol is contraindicated in those with mechanical obstruction of die gastrointestinal or genitourinary tracts. Fhtients with secondary glaucoma, iritis, corneal abrasion, or any acute inflammatory disease of the eye should not use die ophtiialmic cholinergic preparations. 

Ophthalmic ointment, drops, or taping the eyelids shut to prevent keratitis and corneal abrasion... 

Complete healing of the corneal abrasion with no scarring or vision impairment... 

The five layers of the cornea contain no blood vessels but are nourished by tears, oxygen, and aqueous humor. Minor corneal abrasions heal quickly. Moderate abrasions take 24 to 72 hours to heal. Deep scratches may scar the cornea and require corneal transplant if vision is impaired. Do not use eye patches to treat corneal abrasion, as they decrease oxygen delivery, increase pain, and increase the chance of infection.3... 

Topical non-steroidal anti-inflammatory drugs (NSAIDs) decrease pain from corneal abrasion. Available ocular NSAIDs are diclofenac 0.1%, ketorolac 0.5%, nepafenac... 

Because an infection slows the healing of a corneal abrasion, prophylactic antibiotics are often used. Studies on the efficacy of this are mixed. Discontinue the use of contact lenses until the abrasion is healed and the antibiotic course complete. In contact lens wearers, choose an antibiotic that covers Pseudomonas aeruginosa, like gentamicin ointment or solution or a fluoroquinolone.3 Antibiotic resistance is an increasing problem. Resistance occurs primarily with older antibiotics, but has been reported for fluoroquinolones as well. Two newer fluoroquinolones, gatifloxacin and moxifloxacin, do not yet have reports of resistance. These agents are more expensive.6... 

Blunt trauma to eye Macular edema Retinal detachment Sudden congestive proptosis (bulging of eye forward) Corneal ulcer Corneal abrasion... 

Preferred Practice Patterns from the American Academy of Ophthalmology. Online at http //www.aao.org/aao/education/ library/ppp/index.cfm. Available for keratitis, blepharitis, conjunctivitis, dry eye, and age-related macular degeneration. Wilson SA, Last A. Management of corneal abrasions. Am Fam Physician 2004 70 123-128. 

Diagnostic drugs, such as sodium fluorescein, are administered topically or intravenously to aid in the diagnosis of such conditions as corneal abrasions or ulceration and various retinopathies. This agent has become the most widely used diagnostic agent in the... 

V f/T enfs - The primary purpose for an ophthalmic ointment vehicle is to prolong drug contact time with the external ocular surface. This is particularly useful for treating children, who may cry out topically applied solutions, and for medicating ocular injuries, such as corneal abrasions, when the eye is to be patched. Administer solutions before ointments. Ointments preclude entry of subseguent drops. 

Corneal abrasion Use carbachol with caution in the presence of corneal abrasion to avoid excessive penetration. 

An ophthalmic preparation seems to be efficacious for conjunctival inflammation and to reduce pain after traumatic corneal abrasion. Gingival inflammation is reduced after administration of indomethacin oral rinse. Epidural injections produce a degree of pain relief similar to that achieved with methylprednisolone in postlaminectomy syndrome. 

Indomethacin enjoys the usual indications for use in rheumatic conditions and is particularly popular for gout and ankylosing spondylitis. In addition, it has been used to treat patent ductus arteriosus. Indomethacin has been tried in numerous small or uncontrolled trials for many conditions, including Sweet s syndrome, juvenile rheumatoid arthritis, pleurisy, nephrotic syndrome, diabetes insipidus, urticarial vasculitis, postepisiotomy pain, and prophylaxis of heterotopic ossification in arthroplasty, and many others. An ophthalmic preparation seems to be efficacious for conjunctival inflammation (alone and in combination with gentamicin) to reduce pain after traumatic corneal abrasion. Gingival inflammation is reduced after administration of indomethacin oral rinse. Epidural injections produce a degree of pain relief similar to that achieved with methylprednisolone in postlaminectomy syndrome. 

Capsaicin causes conjunctivitis, periorbital edema/ erythema, ophthalmodynia, blepharospasm, blepharitis, corneal abrasions, and lacrimation. In a retrospective study of 81 patients who presented to the emergency department following aerosol exposure from law enforcement use of OC, 56% of individuals developed ophthalmodynia, 44% conjunctivitis, 40% conjunctival erythema, 13% lacrimation, and 9% comeal abrasions (Watson et al, 1996). Another study involved exposure of 47 human volunteers to OC for evaluating effects on the cornea and conjunctivae (Zolhnan et al, 2000). All subjects reported significant eye pain, blurred vision, and lacrimation 10 min after exposure to OC pepper spray, but symptoms improved by 1 h later. Comeal abrasions were not apparent, but 21% of subjects showed evidence of punctate epithelial erosions and reduced comeal sensitivity. Comeal abnormalities were absent 1 week after exposure. Another human study identified 23% of subjects (7 of 30) with comeal abrasions following aerosol exposure to OC spray (Watson et al, 1996). In mice, a single subcutaneous injection of 12.5, 25,... 

Abuse of topically administered drugs by practitioners or patients can cause significant ocular toxicity. Infiltrative keratitis has occurred from long-term use of anesthetic eyedrops for relief of pain associated with corneal abrasions. Bilateral posterior subcapsular cataracts have developed after the topical administration of prednisolone acetate 0.12% twice daily over long durations. Practitioners should closely monitor patients treated with drugs known to have potentially significant ocular or systemic side effects. 

Ointments can be used routinely for superficial corneal abrasions. However, any abrasion involving corneal tissues deeper than the epithelium should be managed on an individual basis depending on the configuration of the wound edges. 

Calder LA, Balasubramanian S, Fergusson D.Topical nonsteroidal anti-inflammatory drugs for corneal abrasions meta-analysis of randomized trials.Acad Emerg Med 2005 12 467-473. 

Polymer-based artificial tears are the most common tear supplementation product used in dry eye treatment. In addition to dry eye, ocular lubricants are used in the treatment of corneal abrasions, ultraviolet keratitis, herpes simplex and zoster keratitis, phlyctenular disease, giant papillary conjunctivitis, superior limbic keratoconjimc-tivitis, vernal disease, adenoviral infections, and other ocular surfece conditions. 

As with the evaluation of corneal abrasions, the application of one or two drops of 0.5% proparacaine is often necessary to allow adequate examination of the eye with a corneal or conjunctival foreign body, ft is advisable to obtain informed consent, preferably written, before proceeding with any minor surgical procedure. 

Both conditions can cause a wide range of symptoms, the most common a foreign body sensation and a red irritated eye. Severe or debilitating symptomatology is a result of corneal surface damage, including corneal abrasion and superficial punctate keratitis. Corneal hypoesthesia with subsequent neurotrophic ulceration is also possible. 

Once the glue is instilled into the eye, it causes an instantaneous tarsorrhaphy, total or partial, due to the apposition of the upper and lower eyelashes or, less commonly, a total ankyloblepharon. Corneal abrasion, SPK, eyelash loss, skin excoriation, and conjunctivitis can also occur, and immediate irrigation is indicated if possible. 

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