Foreign body sensation

The most common adverse reactions leading to discontinuation include device-related problems (eg, foreign body sensations, coital problems, device expulsion). 

Although side effects are usually mild, treatment with brimonidine tartrate includes oral dryness, ocular hyperemia, burning and stinging, headache, visual blurring, foreign body sensation, fatigue drowsiness, ovular allergic reactions, and ocular pruritus. 

Adverse reactions associated with use of the carbonic anyhydrase inhibitors include ocular burning, stinging, or discomfort immediately after administration, bitter taste, ocular allergic reaction, blurred vision, tearing, dryness, dermatitis, foreign body sensation, ocular discomfort, photophobia, and headache. 

Although mild, the adverse reactions associated with the mast cell inhibitors include headache, rhinitis, unpleasant taste, asthma, and cold/flu symptoms. These drug may also cause ocular burning or irritation, dry eye, eye redness, foreign body sensation, and ocular discomfort. 

Adverse reactions associated with administration of the corticosteroid ophthalmic preparations include elevated IOP with optic nerve damage, loss of visual acuity, cataract formation, delayed wound healing, secondary ocular infection, exacerbation of comeal infections, dry eyes, ptosis, blurred vision, discharge, ocular pain, foreign body sensation, and pruritus. 

The administration of die antiviral ophthalmics may cause occasional irritation, pain, pruritus, inflammation, or edema of the eyes or lids allergic reactions foreign body sensation photophobia and corneal clouding. 

Ocular eye involvement is common and may precede skin lesions. Ocular symptoms include foreign body sensation, burning or stinging, dryness, itching, ocular photosensitivity, teleangectasia, periorbital edema, chalazia (Fig. 17.8)... 

Local side effects include burning, stinging, itching, foreign body sensation, dry eyes, and conjunctivitis. Brinzolamide may have a lower incidence of these side effects since the drug is in a neutral pH solution. Dorzolamide has been reported to cause irreversible corneal decompensation. Taste abnormalities have been reported with each agent. Both topical carbonic anhydrase inhibitors are sulfonamides and are contraindicated in patients with history of sulfonamide hypersensitivity.10,13... 

Lodoxamide 1-2 drops in affected eye(s) four times daily Ocular stinging, foreign body sensation... 

Dry or foreign body sensation Mild itching Burning Stinging Photophobia... 

Ophthalmic - Bimatoprost-associated ocular adverse events that occurred in 3% to 10% of patients, in descending order of incidence, included the following Ocular dryness, visual disturbances, ocular burning, foreign body sensation, eye pain, pigmentation of the periocular skin, blepharitis, cataract, superficial punctate keratitis, eyelid erythema, ocular irritation, eyelash darkening. 

Ophthalmic - Latanoprost-associated ocular adverse events reported at an incidence of 5% to 15% included the following Blurred vision, burning and stinging, conjunctival hyperemia, foreign body sensation, itching, increased pigmentation of the iris, punctate epithelial keratopathy. 

Adverse reactions occurring in at least 3% of patients include transient burning, stinging or discomfort upon instillation ocular itching/pruritus blurred vision dry eye tearing/discharge hyperemia crystalline deposits and foreign body sensation. 

Ciprofloxacin White crystalline precipitates lid margin crusting crystals/scales foreign body sensation itching conjunctival hyperemia bad taste in mouth corneal staining keratopathy/keratitis allergic reactions lid edema tearing photophobia corneal infiltrates nausea decreased vision. 

Ophthalmic- Local burning or discomfort, margin crusting, crystals or scales, foreign body sensation, ocular itching, altered taste Rare (less than 1 %)... 

Ocular itching, blurred vision, dry eye, tearing/discharge/foreign body sensation,... 

Ocular pain, pruritus, eye discomfort, decreased visual acuity, foreign body sensation Rare... 

Abnormal vision, eyelid disorder, foreign body sensation. 

A 15-year-old boy felt a foreign body sensation in his right eye after he had been raking hay. His local physician prescribed a suspension of tobramycin 0.3% + dexamethasone 0.1% tds, but 6 days later referred him for evaluation of a suspected fungal keratitis. He had a corneal epithelial defect with an underlying dense... 

Presoaked lenses are considered a more efficient and reliable delivery system. However, the soaking of lenses in ophthalmic formulations to incorporate the drag into the lens may cause toxicity to corneal epithelium because preservatives, such as benzalkonium chloride, have a great affinity for the hydrophilic contact lens material and are concentrated in the contact lens. Contact lens for sensitive wearers may also cause foreign-body sensation, blurring and decreased oxygen tension on the corneal surface resulting from occlusion by contact lens. 

An alternative system, manufactured as a wafer-like insoluble implant, has been developed (Ocusert). The system is preprogrammed to release pilocarpine at a constant rate of 20 or 40 / g/hr for a week to treat chronic glaucoma however, release from inserts may be incomplete and approximately 20% of all patients treated with the Ocusert lose the device without being aware of the loss. The device also presents problems including foreign-body sensation, expulsion from the eye, and difficulty in handling and insertion. An alternative to the advanced non-erodible systems is an erodible insert for placement in the cul-de-sac. 

Ocular inserts probably represent one of the oldest ophthalmic formulation approaches. In 1948 the British Pharmacopoeia described an atropine-in-gelatin wafer and ever since then numerous systems have been developed applying various polymers and different release principals. However, the difficulty of insertion by the patient, foreign-body sensation, and inadvertent loss of inserts from the eye make these systems less popular, especially among the elderly. Furthermore, the high cost involved in manufacture prevented the insert market from taking off [197],... 

Dorzolamide is generally well tolerated. Ocular side effects include local irritation, possibly related to pH and tonicity. Stinging (7%), burning or foreign body sensation (12%), and blurring of vision (9%) are among the most common. Others include superficial punctate keratitis and headache. A severe sterile purulent conjunctivitis developing over weeks to months was described in seven patients and resolved on discontinuation of dorzolamide. Because all CAIs are sulfonamides, local sensitization has... 

Oxymetazoline is available as an ocular decongestant at the 0.025% concentration. Oxymetazoline has been demonstrated to be useful in patients with allergic conjunctivitis and has been demonstrated to improve symptoms of burning, itching, tearing, and foreign body sensation in patients with moderate to severe conjunctival hyperemia. Onset of action can be as early as 5 minutes after instillation, with peak effects at 60 minutes, and the effect can last up to 6 hours. Oxymetazoline 0.025% does not seem to alter lOP or affect pupil size or accommodation. 

Adverse reactions for these multiaction drugs include burning, foreign body sensation, dry eye, and pruritus. Systemic side effects may include headache, flu-like syndrome, and rhinitis. Most common to all these drugs is headache and burning and stinging. Table 13-7 delineates the various adverse reactions. 

Clinical studies indicate that the insert can be beneficial in the treatment of certain dry eye syndromes. Some patients may experience relief of symptoms of burning, photophobia, and foreign body sensation. Corneal abnormalities and rose bengal staining of cornea and conjunctiva... 

The device is generally comfortable and well accepted by many patients, but its use does have certain disadvantages. Some patients have problems with discomfort (foreign body sensation) or expulsion of the Lacrisert.The insert can be wetted with saline before insertion to improve comfort, but this can make even more difficult the insert s placement into the lower cul-de-sac, which requires a moderate amount of dexterity. Supplementation with artificial tears after insertion may improve comfort. The most common patient complaint is blurred vision associated with the intense release of polymer during the first 4 to 6 hours after instillation, from a thickened tear film.Adding such fluid as drops of NaCl 0.9% or artificial tear solution can reduce the tear film viscosity and minimize the visual complaints. As the insert dissolves it releases debris that can blur vision and cause irritation. Most patients with mild signs and symptoms of dry eye do not experience improvement with use of the insert, as compared with the use of conventional tear solutions. Because some tear secretion is necessary to dissolve the Lacrisert, KCS patients with low basal tear secretion may not benefit from or tolerate its use. 

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