Raiyyan Tahsan

Raiyyan Tahsan
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Ophthalmology Case No 3.Eye Diseases

OPHTHALMOLOGY NOTES

                                Common symptoms of ophthalmology

1. Vision Changes:

Blurred vision

Double vision (diplopia)

Sudden vision loss (partial or complete)

Difficulty seeing at night (nyctalopia)

Light sensitivity (photophobia)

2. Eye Discomfort & Pain:

Eye redness

Burning or itching sensation

Foreign body sensation

Eye strain or fatigue

                                     Common optical examination

1. Visual Acuity Test

Snellen Chart – Measures how well a patient can see at a distance.

2. Pupil Examination

Direct and Consensual Light Reflex – Tests pupillary reaction to light.

Swinging Flashlight Test (RAPD Test) – Detects optic nerve dysfunction.

3. Intraocular Pressure Measurement

Tonometry (Goldmann, Non-contact, or Schiotz) – Measures eye pressure for glaucoma screening.

4. Slit Lamp Examination

Uses a microscope and high-intensity light to inspect the cornea, lens, anterior chamber, and other anterior eye structures.

5. Fundoscopy (Ophthalmoscopy)

Direct Ophthalmoscopy – Quick retina and optic disc evaluation.

Indirect Ophthalmoscopy – Provides a wider and more detailed retinal view.

6. Color Vision Testing

Ishihara Test – Detects red-green color blindness.

7. Visual Field Testing

Confrontation Visual Field Test – Basic assessment for peripheral vision loss.

Automated Perimetry (Humphrey or Goldmann) – More detailed mapping of visual field defects.

8. Fluorescein Staining & Tear Film Tests

Fluorescein Staining – Detects corneal abrasions, ulcers, or dry eye.

                             Abnormal Eye Appearance or Movement

Swelling around the eyes

Droopy eyelids (ptosis)

Misaligned eyes (strabismus)

Involuntary eye movement (nystagmus)

Discharge & Tearing Issues:

Excessive tearing (epiphora)

Dry eyes

Yellow or green discharge (indicating infection)

Flashes, Floaters & Other Visual Disturbances:

Seeing flashes of light

Floaters (small spots moving in vision)

Halos around lights

Dark curtain-like shadow over vision (could indicate retinal detachment)

                             Common Drugs of Ophthalmology

1. Antibiotics (for bacterial infections):-

Moxifloxacin/ Optimox(0.5% eye drops): 1 drop every 2 hours for the first 2 days, then every 4–6 hours for 7–14 days or, 1 drop in eye 3 times daily for 7 days.

Eye drop 1.Iventi 0.5%(AS A  Moxifloxacin Hydrochloride 5ml drop AS A Ophthalmic antibacterial drugs).

Tobramycin/ Cinarex (0.3% eye drops): 1–2 drops every 4–6 hours for 7–10 days.

Chloramphenicol/Chloram (0.5% eye drops, 1% ointment): 1 drop every 2–4 hours or apply ointment 4 times daily for 7 days.

Ciprofloxacin/Neofloxin (0.3% eye drops): 1–2 drops every 2 hours for the first 2 days, then every 4–6 hours for 7–14 days.

2. Antivirals (for viral infections):-

Acyclovir/ Virux (400 mg oral tablet): 400 mg five times daily for 7–14 days in herpes simplex keratitis.

Ganciclovir (0.15% eye gel): 1 drop five times daily until healing, then three times daily for 7–21 days in herpes simplex keratitis.

Eye Gel 1.Xoviral 0.15% (Ganciclovir AS A 5gm tube Ophthalmic Anti-viral Products).

3. Anti-inflammatory & Steroids:-

Prednisolone acetate (1% eye drops): 1 drop every 1–2 hours initially, then taper over 2–4 weeks for uveitis or post-surgical inflammation.

Eye Drop 1.Cortisol 1% 5ml drop (AS A Prednisolone acetate AS A Glucocorticoids).

Dexamethasone (0.1% eye drops): 1 drop every 4–6 hours for 1–4 weeks.

Or,

Eye drop 1.Sonexa 0.1% 5ml drop (AS A Dexamethasone AS A cortisone Steroid.)

Eye Ointment 2. Sonexa 0.05% 3gm tube (AS A Dexamethasone AS A cortisone Steroid.)

Regimen of Steroid with standard tapering:-

Cortan 1% Eye drop or Dexamethasone eye drop 0.1%:

1 drop in affected eye-4 hourly—–10 days

1 drop in affected eye 6 hourly—- 10 days

1 drop in affected eye 8 hourly—- 10 days

1 drop in affected eye 12 hourly—- 20 days

4. Anti-Glaucoma Medications:-

Timolol (0.25%–0.5% eye drops)/ Timopress ED: 1 drop twice daily for long-term glaucoma management.

Eye Drop 1. Timopress 0.5%  5ml drop (Timolol Maleate Drugs for miotics and glaucoma).

Other Preparation Of Timolol:-

1.(Brimonidine Tartrate +Timolol Maleate):-

Eye drop 1.Brimodin Plus (0.2%+0.5%) 5ml drop (AS A (Brimonidine Tartrate +Timolol Maleate) AS A Drugs for miotics and glaucoma).

2.(Brinzolamide +Brimonidine Tartrate):-

Eye Drop 2.Zolaren Plus (1%+0.2%) 5ml Drop (AS A (Brinzolamide +Brimonidine Tartrate) AS A Drugs for miotics and glaucoma).

Latanoprost (0.005% eye drops): 1 drop at bedtime for long-term use in glaucoma.

Eye drop 1.Xalatan 0.005% 2.5ml drop (AS A Latanoprost AS A Drugs for miotics and glaucoma).

Other Component Of Latanoprost:-

  1. Latanoprost+Timolol:-

Eye Drop 1.Xalacom (0.005%+0.5%) 2.5ml drop (AS A (Latanoprost+Timolol) AS A Drugs for miotics and glaucoma)

2.Netarsudil+ Latanoprost:-

Eye drop 2.Nesudil Plus 0.02%+0.005% 3ml Drop (AS A (Netarsudil+ Latanoprost) AS A Drugs for miotics and glaucoma).

3.Latanoprostene Bunod:-

Eye Drop 1.Zultan 0.024% 3ml drop (AS A Latanoprostene Bunod AS A Drugs for miotics and glaucoma).

Acetazolamide (250 mg oral tablet): 250 mg 2–4 times daily for acute angle-closure glaucoma (short-term).

Tablet 1.Acemox 250 mg (AS A Acetazolamide AS A Carbonic anhydrase inhibitor).

Pilocarpine/ Pilo  2% ED:

1 drop in both eyes 4 hourly.

Eye Drop 1.Resight 1.25% 2.5ml drop (AS A Pilocarpine Hydrochloride AS A Drugs affecting exocrine secretions).

5. Mydriatics & Cycloplegics (for pupil dilation & ciliary muscle paralysis):-

Tropicamide (0.5%–1% eye drops): 1 drop every 5–10 minutes (maximum two drops) for pupil dilation lasting 4–6 hours.

Or, Eye drop 1.Tropicam 1%, 5ml drop (AS A Tropicamide  AS A Mydriatic and Cycloplegic agents) 1 drop 8 hourly.

Other preparation Of Tropicamide:-

1.Tropicamide +Phenylephrine + Lidocaine:-

Injection 1.Midoria (Intracameral Injection) (0.02%+0.31%+1% ) 0.6ml ampoule AS A (Tropicamide +Phenylephrine + Lidocaine) (AS A Other ophthalmic preparations).

  • Tropicamide+Phenylephrine Hydrochloride:-

Eye drop 1.Dilate Plus (0.8%+5% ) 5ml drop AS A (Tropicamide+Phenylephrine Hydrochloride) (AS A Preparations for Ophthalmic diagnosis).

Atropine (1% eye drops): 1 drop two to three times daily for 7–14 days in uveitis.

Eye drop 1.Atrogen 1% 10ml drop (AS A Atropine Sulfate Mydriatic and Cycloplegic agents).

Eye Ointment 2. Atrogen 1% 3gm tube drop (AS A Atropine Sulfate Mydriatic and Cycloplegic agents).

6. Local Anesthetics (for procedures & diagnostics):-

Proparacaine (0.5% eye drops): 1 drop every 5–10 minutes, used only for procedures.

Eye drop 1.Procain 0.5% 10ml drop (AS A Proparacaine Hydrochloride Ocular perioperative drugs).

Tetracaine (0.5% eye drops): 1 drop every 5–10 minutes for short-term procedures.

Eye Gel 1.Instasia (14%+2%+2%) 30gm tube (AS A (Benzocaine +Butamben +Tetracaine Hydrochloride ) AS A Topical Local Anesthetics).

7. Lubricants & Artificial Tears (for dry eyes):-

Carboxymethylcellulose/Lubgel/ Tearfresh 1% (0.5%–1% eye drops): 1 drop every 4–6 hours or as needed for long-term use.

Eye drop 1.Lubgel 1% 10ml drop (AS A Carboxymethylcellulose Sodium AS A ocular lubricant).

Other Preparation of Carboxymethylcellulose:-

  1. Carboxymethylcellulose Sodium+Glycerin:-

Eye drop 1.Neotear (0.5%+0.9%) 10ml drop (AS A (Carboxymethylcellulose Sodium+Glycerin) AS A Drugs for Dry eyes)

2.(Sodium Hyaluronate + Carboxymethylcellulose Sodium):-

Eye Drop 1.Opti Fusion 0.1%+0.5% 10ml drop AS A .(Sodium Hyaluronate + Carboxymethylcellulose Sodium) (AS A Drugs for Dry eyes).

  • Carboxymethylcellulose Sodium+Hypromellose:-

Eye Gel 1.Lubric Extra 0.25%+0.3% 10ml drop (AS A Carboxymethylcellulose Sodium+Hypromellose ) (AS A Drugs for Dry eyes)

Hypromellose/ Lubric 0.5% (0.3% eye drops): 1 drop every 4–6 hours or as needed for long-term use

Eye drop 1.Lubric 0.5% 10ml drop (AS A Hypromellose AS A Drugs for Dry eyes).

Other Preparation of Hypromellose:-

1.Glycerin + Hypromellose+Polyethylene Glycol +Tetrahydrozoline +Zinc Sulfate:-

Eye Drop 1.Tearfil (0.2%+0.36%+1%+0.05%+0.25% ) 10ml drop (AS A Glycerin + Hypromellose+Polyethylene Glycol +Tetrahydrozoline +Zinc Sulfate) (AS A Other ophthalmic preparations).

2.Dextran+Hypromellose :-

Eye Drop 1.Lubric-D (0.1%+0.3%) 10ml drop AS A (Dextran+Hypromellose) (AS A Drugs for Dry eyes).

3.Glycerol + Hypromellose+ Polyethylene Glycol 400:-

Eye Drop 1.Visitear (0.2%+0.36%+1% ) 10ml drop (AS A Glycerol + Hypromellose+ Polyethylene Glycol 400) (AS A Drugs for Dry eyes).

4. Hypromellose+Carbomer:-

Eye Gel 1.Hypomer (0.3%+0.22% ) 10gm tube AS A (Hypromellose+Carbomer) (AS A Drugs for Dry eyes).

5.Carboxymethycellulose Sodium+ Hypromellose:-

Eye Gel 1.Lubric Extra (0.25%+0.3%) 10 ml drop (AS A  Carboxymethycellulose Sodium+ Hypromellose ) (AS A Drugs for Dry eyes).

                                            Important Notes

Steroids should not be used in viral or fungal infections unless prescribed by an ophthalmologist.

Glaucoma medications are typically lifelong treatments.

Antibiotics should be used for the full duration prescribed to prevent resistance.

Anesthetics are for diagnostic/procedural use only and should not be used frequently as they can damage the cornea.

                                    Sample treatment

                                             Uveitis

  1. Atropin eye drop 1%- 1 drop in eye  —-6 hourly.
  2. Dexon 0.05% eye drop 

Mild case: 1 drop —– 6hourly

Moderate case: 1 drop —–2 hourly

Severe case: 1 drop—–1/2 hourly.

  • Tab. Cortan 5 mg

2+0+0—–7 days

1+0+0—–7 days

½+0+0——7 days

  • Tab. Diclofen 25mg (1+0+1)—–5 days
  • Tab. Ranison 150 mg—-1+0+1—-5 days
  • Tab. Lexotanil 3 mg—0+0+1—-10 days.

                                                                                              Signature

                             Optical surgery

1. Cataract Surgery

Phacoemulsification – The most common cataract removal technique using ultrasound to break and remove the cloudy lens, followed by implantation of an intraocular lens (IOL).

Extracapsular Cataract Extraction (ECCE) – Removal of the lens while keeping the capsule intact, used when phacoemulsification is not possible.

2. Glaucoma Surgery

Trabeculectomy – A filtration surgery to create an opening in the sclera to drain excess intraocular fluid and lower eye pressure.

Laser Trabeculoplasty (ALT/SLT) – Laser treatment to improve fluid drainage in open-angle glaucoma.

3. Corneal Surgery

Penetrating Keratoplasty (Corneal Transplant) – Full-thickness corneal replacement for severe corneal disease.

Descemet’s Stripping Endothelial Keratoplasty (DSEK/DMEK) – Partial corneal transplants for endothelial disorders.

Pterygium Excision – Removal of abnormal conjunctival tissue growth extending onto the cornea.

4. Retinal Surgery

Vitrectomy – Removal of the vitreous gel to treat retinal detachment, vitreous hemorrhage, or macular hole.

Laser Photocoagulation – Laser treatment to seal retinal tears or treat diabetic retinopathy.

5. Oculoplastic & Reconstructive Surgery

Dacryocystorhinostomy (DCR) – A procedure to create a new tear drainage pathway in blocked tear ducts.

Enucleation/Evisceration – Removal of the eye in cases of severe trauma or cancer.

6. Refractive Surgery

LASIK (Laser-Assisted in Situ Keratomileusis) – Laser surgery to correct refractive errors like myopia and hyperopia.

PRK (Photorefractive Keratectomy) – An alternative to LASIK for corneal reshaping.

7. Other Minor Ophthalmic Procedures

Chalazion Excision – Removal of a blocked meibomian gland cyst.

Foreign Body Removal – Removal of debris or objects from the cornea or conjunctiva.

YAG Laser Capsulotomy – Performed after cataract surgery to treat posterior capsule opacification.

Raiyyan Tahsan Date:-5-02-2025 Wednesday Time:-4-52-34 Pm

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