Eye drop

In humans, the adult eyeball measures approximately one inch (2.5 centimeters) in diameter, and of its total surface area, only the anterior one-sixth is exposed to the external environment. This exposed area is protected by accessory structures of the eye, including the eyelids, eyelashes, eyebrows, lacrimal (tearing) apparatus, and extrinsic eye muscles. Each eyelid possesses a conjunctiva, which is a thin, transparent, and protective mucus membrane. The conjunctiva lines the inner aspect of the eyelids as the palpebral conjunctiva and folds back (reflects) over the eyelids onto the anterior exposed surface of the eyeball as the bulbar (ocular) conjunctiva. The bulbar conjunctiva covers only the white of tlae eye (not the cornea that covers over the iris and pupil). Because tlie bulbar conjunctiva is quite thin, blood vessels are clearly visible beneath it. When these blood vessels are dilated and congested from local irritation or infection (conjunctivitis, or inflammation of the conjunctiva), the result is the appearance of reddened and irritated bloodshot eyes. 

The term vulva (or pudendum ) refers to the external genitalia of the human female. The vulva includes the mons pubis, labia, clitoris, and structures associated with the vestibule. Located anterior to the vaginal and urethral openings, the mons pubis is a rounded elevation of adipose tissue covered by skin and coarse pubic hair that overlies and protects the 

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Astemi2ole (10) has further been modified into a series of 4-phenylcyclohexylamine compounds, resulting in the synthesis of cabastine, for example. Cabastine is a highly active compound and its geometric isomers are also active, demonstrating the stereoselectivity of histamine receptors toward chiral ligands. The > S, 4 R-levo antipode of cabastine was the most active, and therefore this isomer, levocabastine (13), has been chosen for further development. Because of high potency, levocabastine has been developed for topical appHcation such as eye drops and nasal spray. 

Ophthalmic Dosage Forms. Ophthalmic preparations can be solutions, eg, eye drops, eyewashes, ointments, or aqueous suspensions (30). They must be sterile and any suspended dmg particles must be of a very fine particle size. Solutions must be particle free and isotonic with tears. Thus, the osmotic pressure must equal that of normal saline (0.9% sodium chloride) solution. Hypotonic solutions are adjusted to be isotonic by addition of calculated amounts of tonicity adjusters, eg, sodium chloride, boric acid, or sodium nitrate. 

The daily oral dose of diclofenac is 50-150 mg. Diclofenac is also available as eye-drops for the treatment of non-specific inflammation of the eye and for the local therapy of eye pain. 

Additional education regarding special considerations of certain drugs, such as techniques for giving injections, applying topical patches, or instilling eye drops... 

GLAUCOMA When a cholinergic drug is prescribed for glaucoma, the nurse instructs tlie patient and a family member in instillation of the eye drops (see Fhtient and Family Teaching Checklist Instilling Liquid Eye Medications). 

If a family member is to install tlie drug, tlie nurse allows time for instruction as well as supervised practice of the procedure The nurse warns tlie patient that tlie eye drops may sting when instilled into the eye and that this is a normal, but often temporary, discomfort. The nurse advises the patient to observe caution while driving or performing any task that requires visual acuity. 

Explains that if tlie patient or caregiver is unable to instill eye drops, tlie primary health care provider should be contacted immediately. 

A patient with glaucoma is prescribed pilocarpine eye drops. One adverse reaction that the nurse will expect with the use of this drug is. ... 

The primary care provider allows the patient to keep pilocarpine eye drops at the bedside and to self-administer the eye drops 4 times daily. The nurse... 

A. need not check with the patient concerning the eye drops because the patient is a responsible adult... 

When a patient is scheduled for eye surgery, it is most important that the eye drops ordered by the primary health care provider are instilled at the correct time. This is especially important when the purpose of the drug is to change the size of the pupil. 

Ms. Stone, age 76 years, has glaucoma and is prescribed timolol (Timoptic) eye drops. Your initial assessment reveals that she has severe arthritis and appears to have difficulty following instructions. Discuss any further investigations you feel are important to make before developing a teaching plan for this patient. 

Because of shortened hospital stays and inoreases in the number of ambulatory surgeries tor many eye problems, the patient may be required to instill eye drops or ointment at home. If the patient is unable to do so, a family member or friend may have to instill the preparation, the nurse uses the following guide to evaluate that the patient or caregiver can properly instill the e drops or ointment ... 

Replaces the cap of the eye preparation immediately after instilling the eye drops or ointment. Does not touch the tip of the dropper, bottle, or tube. 

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