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Structure of the Eye
 The following are the major areas of the eye and its
function
 Cornea: covers the iris and pupil
 Sclera is the white part of the eye and the conjunctiva is the
clear membrane that covers it
 Iris and the pupil form the aperture that light passes through
to the lens
 Lens focuses light by refraction to the back of the globe to the
retina
 The retina is a collection of neurons that triggers the optic
nerve and carries the “image” to the occipital lobe of the brain
 The eye contains two chambers as well. The aqueous
humor which is filled with water and the vitreous
humor in the back of the eye
 The lens is controlled by the muscles of the ciliary
body which adjusts the lens to control refraction of
light
 The basic function of the eye is to focus and
concentrate light waves to a focal point on the retina
which converts it to electrical impulses (EI). EI are
carried to the brain via the optic nerve
 Source: http://www.disabled-world.com/artman/publish/eye-color.shtml
Infections of the eye
 Style: a bacterial infection of the sebaceous glands of the
eye lid. Antibiotics like ophthalmic erythromycin can be
used but infection is self limited and will resolve in usually
seven days
 Blepharitis: inflammation of the eyelids cause by usually
bacteria. Tx: Blephamide® (prednisolone/sulfacetamide) is
a combination Abx/steroid used to treat this disorder
 Conjunctivitis is an inflammation of the conjunctival
membrane of the eye.
 Allergic conjunctivitis (red eye)
 Bacterial conjunctivitis
 Viral conjunctivitis (Pink eye)
Allergic Conjunctivitis
 Inflammatory condition of the conjunctiva caused by
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seasonal allergies and airborne allergens
Called “red eye”
Intensive itching
Eye watering
Tx: Ophthalmic antihistamines products: (Visine A®
naphazoline 0.025% and pheniramine 0.03%) or
Patanol®, olapadine which is Rx only antihistamine
Bacterial Conjunctivitis
 Caused by mixture of different bacterial
 Symptoms same as for allergic conjunctivitis
 In addition pus and mucus causes the lids to “stick
together”. This is the hallmark of this infection
 Usually resolves on its own but antibiotics can be used
 Ciprofloxacin 0.3% (ciloxan®), Erythromycin
Ophthalmic Ointment USP, 0.5% and others
Neonatal Ophthalmia
 Women infected with chlamydia or gonorrhea can pass
bacteria to their infants as they pass through birth
canal
 Erythromycin ophthalmic ointment 0.5% USP has
been used to treat the infants
 Can cause blindness if not treated
Viral Conjunctivitis
 Commonly called pink eye
 Commonly caused by the same viruses causing the
common cold (adenovirus)
 Other virus can include varicella and herpes simplex
virus
 No therapy except supportive. Oral acyclovir is used
for cases caused by varicella zoster virus or herpes
simplex virus.
Glaucoma
 Glaucoma is a disease of the eye where the pressure
inside the eye ball is elevated above normal
 Treated with drugs that reduce the pressure in the
eyeball by relaxing the trabecular network and
increase aqueous humor outflow.
Brand drug
Generic
MOA
Timoptic ®
Timolol
Beta Blocker
Betagan ®
Levobunolol
Beta Blocker
Trusopt ®
Dorzolamide
Carbonic
Anhydrase
Inhibitor
Azopt ®
Brinzolamide
Carbonic
Anhydrase
Inhibitor
Xalatan®
Latanoprost
Prostaglandin
Lumigan®
Bimatoprost
Prostaglandin
Travatan®
Travoprost
Prostaglandin
General structure of the ear
 The outer ear consists of the pinna and auricle
 Auditory canal leads from the outer ear to the
tymphanic membrane (ear drum)
 Middle ear: the three ossicles vibrate in response to
sound waves and transmit the energy of the sound
waves into the inner ear
 Inner ear: The cochlea is a conical shape organ filled
with fluid and lined with hair cells. The energy of
sound waves is transmitted here and the movement of
hair cells to electrical action potentials in cochlear
nerve (CN VIII)
 Infections of the ear are the most commonly treated
malady of the ear
 Medications include otic antibiotics that contain a
combination of antibiotics and a steroid.
 Example is Cortisporin Otic Solution (neomycin and
polymyxin B sulfates and hydrocortisone otic solution,
USP) is a sterile antibacterial and anti-inflammatory
solution for otic use. Each mL contains: neomycin
sulfate equivalent to 3.5 mg neomycin base, polymyxin B
sulfate equivalent to 10,000 polymyxin B units, and
hydrocortisone 10 mg (1%)
Middle Ear Infections
 Bacteria that infect the eustachian tube include:
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Staphylococcus pyogenes, Streptococcus pneumoniae,
moraxella species, and haemophilus influenza
Very common in children because of the horizontal nature
of the tube position
Caused intense pressure in the middle ear that can rupture
the eardrum and ozze pus from the ear
Myringitis is the associated inflammation of the eardrum
Called Bacterial Acute Otitis Media
In children, Amoxicillin is normally prescribed usually as
suspension and given three times a day
In refractory cases, Augmentin ® (amoxicillin/clavulunate
sodium) is used
Miscellaneous Drugs
 Parasympathomimetics (Cholinergic drugs)
 MOA: agonists at the cholinergic receptor in the eye
 Indications: pupillary constriction and glaucoma tx
 Drugs
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Pilocarpine (Pilocar)
Carbachol (Miostat)
 Sympathomimetics (mydriasis agents)
 MOA: binds to beta and alpha receptors or blocks cholinergic
receptors
 Indications: dilate the pupil for ophthalmic exams
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Phenylephrine
Cyclopentolate (Cyclogyl)
Atropine