The adjustment of the lens of the eye for variations in distance (p.903)

Glaucoma that occurs as a result of a narrowed anatomic angle between the lens and cornea.  AKA - closed-angle glaucoma, narrow-angle glaucoma, congestive glaucoma, and pupillary closure glaucoma

The bubble-like portion of the front of the eye between the iris and the cornea (p.903).

 The clear, watery fluid circulatin in the anterior and posterior chambers of the eye (p.903).

A tiny circular vein at the angle of the anterior chamber of the eye through which the aqueous humor is drained and ultimately funneled into the bloodstream (p.903).

An abnormal progressive condition of the lens of the eye, characterized by loss of transparency with resultant blurred vision (p.903).

The circular muscle between the anterior and posterior chambers of the eye behind the iris.  It is connected to the suspensory ligaments that control the curvature of the lens (p.903).

Photoreceptive (light-receiving) cells in the retina of the eye that enable a person to perceive colors and play a large role in central (straight-ahead) vision (p.903).

The convex, transparent anterior part of the eye (p.902).

Paralysis of the ciliary muscles, which prevents the accomodation of the lens for variations in distance (p.903).

Drugs that paralyze the ciliary muscles of the eye (p.903).

A muscle that constricts the iris of the eye but dilates the pupil (p.903).

An abnormal condition of elevated pressure within an eye because of obstruction of the outflow of aqueous humor (p.903).

The pressure of the fluids of the eye against the tunics (retina, choroid, and sclera) (p.903).

The round, muscular portion of the eye that gives the eye its color and serves as an aperture controlling the amount of light passing through the pupil.

Small tubes that drain tears from the lacrimal glands into the nasal cavity.

The transparent, curved structure of the eye that is located directly behind the iris and the pupil and is attached to the ciliary body by ligaments.

An enzyme with antiseptic actions that destroys some foreign organisms.  It is normally present in tears, saliva, sweat, and breast milk.

Drugs that constrict the pupil.

Drugs that dilate the pupil.

A type of glaucoma that is often bilateral, develops slowly, is genetically determined, and does not involve a narrowing of the angle between the iris and the cornea.  AKA - chronic glaucoma, wide-angle glaucoma and simple glaucoma.

A major nerve that connects the posterior end of each eye to the brain, to which it transmits visual signals.

A circular opening in the iris of the eye, located slightly to the nasal side of the center of the iris.  The pupil lies behind the anterior chamber of the eye and the cornea and in front of the lens.

The innermost layer of the eye, containing both rods and cones that receive visual stimuli and transmit them to the optic nerve

The photoreceptive elements arranged perpendicularly to the surface of the retina.  Rods are especially sensitive low-intensity light and responsible for black-and-white and peripheral ("off-to-the-side") vision.

A muscle that expands the iris while constricting or narrowing the diameter of the pupil.

Watery saline or alkaline fluid secreted by the lacrimal glands to moisten the conjunctiva.

The fibrous tunic beneath the sclera that includes the iris, the ciliary body, and the choroid of the eye.  Also called tunica vasculosa bulbi and uveal tract.

A transparent, semigelatinous substance contained in a thin membrane filling the cavity behind the lens.  Also called the corpus vitreum.

The fluid component of the vitreous body.

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Acetylcholine

(Miochol-E)

Direct-acting cholinergic drug that is used to produce miosis during ophthalmic surgery.  It is a pharmaceutical form of the naturally occuring neurotransmitter in the body.  It has a very quick onset and may begin to work almost immediately.  It is administered directly into the anterior chamber of the eye before and after securing one or more sutures.

Apraclonidine

(Iopidine)

Structurally and pharmacologically related to alpha₂ stimulant clonidine. Reduces intraocular pressure 23% to 39% by stimulating alpha₂ and beta₂ receptors.  It also prevents ocular vasoconstriction, which reduces ocular blood pressure as well as aqueous humor formation. Primarily used to inhibit perioperative intraocular pressures increases, rather than to treat glaucoma

Near-sightedness

Pilocarpine

(Pilocar)

Direct-acting cholinergic drug that is used as a miotic in the tx of glaucoma.  Available in different strengths as an ocular gel and solution.  One special formulatin is pilocarpine ocular insert system (Ocusert Pilo-20) which is applied once a week by the patient

Ecothiophate

(Phospholine Iodide)

Phosopholine Iodide. An indirect acting cholinergic that has an organophosphate structure and acts by phosphorlating cholinesterase enzymes.  This effect is normally irreversible until new enzymes are synthesized by the body which can take days or weeks.  This drug is considered long lasting.

Dipivefrin

(Propine)

Synthetic sympathomimetic miotic drug.  It is a prodrug of epinephrine that has little or no pharmacological activitiy until hydrolyzed in the eye to chemically modified forms of ephinephrine.  These chemical alterations account for the main advantage of this drug over epinephrine.  Has enhanced lipophilicity (fat solubility) and can better penetrate into the tissues of the anterior chamber of the eye. Reduces intraocular pressure approximately 15%-25%. 

Betaxolol

(Betoptic)

Beta₁- selective blocker.  One of the most potent and selective beta-blocking drugs. Decreases aqueous humor formation and reduce intraocular pressure. Excellent for treating open-angle glaucoma and ocular hypertension

Timolol

(Timoptic)

Differs from other beta blockers in that it may increase the outflow of aqueous humor as well as decrease its formation.  Acts at both beta₁ and beta₂ receptors.  Available in various liquid forms with or without perservatives.  Also available in gel-form which are longer acting.  Treats open-angle glaucoma and ocular hypertension.

Dorzolamide

(Trusopt)

Indicated for treatment of elevated intraocular pressure associated with either ocular hypertension or open-angle glaucoma.  It is a carbonic anhydrase inhibitor.  The other drug in this class is brinzolamide which  has comparable indications, dosages and pharmacokinetics

Glycerin

Osmotic drug given orally to lower intraocular pressure or topically to reduce superficial corneal edema.  Also used prior to iridectomy in individuals with acute narrow-angle glaucoma. Also used preoperatively and/or postoperatively in procedures to tx congenital glaucoma, repair of retinal detachment, cataract extraction and keratoplasty (corneal transplant).  May be used as mgmnt of secondary glaucoma

Mannitol

(Osmitrol)

Administered by IV infusion to reduce elevated intraocular pressure when the pressure cannot be lowered by other means. Effective in treating acute episodes of angle-closure, absolute or secondary glaucoma and in lowering intraocular pressure before intraocular surgery.  It does not penetrate the eye and may be used when irritation is present, unlike some of the other osmotic drugs, such as urea.

Prodrug of a naturally occurring prostaglandin known as prostaglandin F₂-alpha. When administered is converted by hydrolysis (with water from ocular fluids) to prostaglandin F₂-alpha, which in turn reduces intraocular pressure.  Only available in eyedrop form.  About 3% to 10% of patients treated with this med have shown increased iris pigmentation after 3 to 4.5 months of treatment. 

Inflammation of the eyelids

Inflammation of conjunctiva (the mucous membrane lining the back of the eyelids and the front of the eye except the cornea).  It may be bacterial or viral and is often associated with common colds.  When caused by Haemophilus organisms, it is commonly called pink eye.  It is highly contagious but usually self-limiting.

Acute localized infection of the eyelash follicles and the glands of the anterior lid.  It  results in the formation of a small abscess or cyst.

Inflammation of the cornea caused by bacterial infection.  Herpes simplex keratitis is caused by viral infection

Infection of the uveal tract or the vascular layer of the eye, which includes the iris, ciliary body and choroid

Antimicrobials that destroy bacteria by interfering with protein synthesis in bacterial cells, which leads to bacteria death.  Used to treat ocular infections include:

gentamicin (Garamycin) and tobramycin (Tobrex).  Adverse effects include swollen eyelids, mydriasis, and local erythema.

Gentamicin

(Garamycin)

Effective against a wide variety of gram-negative and gram-positive organisms.  It is particularly useful against  Pseudomonas, Proteus, and Klebsiella organisms.  Gram-positive organisms that are effectively destroyed include staphylococci and streptococci that have developed resistance to other antibiotics.  Is available as ointment or solution

Include erythromycin, azithromycin, and other drugs.  Erythromycin is the most commonly used macrolide.

Erythromycin

Macrolide antibiotic indicated for the treatment of various ophthalmic infections, as well as other infections.  Available in oral and IV forms and as an ophthalmic ointment.  The eye ointment  is indicated for the treatment of neonatal conjunctivitis caused by Chlamydia trachomatis and for the prevention of eye infections in newborns that may be caused by Neisseria gonorrhoeae or other susceptible organisms

Bacitracin and polymyxin B are polypeptide antibiotics.  These drugs are rarely used sytemically because of their nephrotoxic effects.  They are bactericidal antimicrobials that inhibit protein synthesis in susceptible organisms, which leads to cell death. 

Bacitracin

(AK-Tracin)

An ophthalmic antimicrobial drug used to treat various eye infections.  It is available as a single ingredient product and as a combination product with polymyxin or neomycin and polymyxin.  The combination products have a broader spectrum of activity.  Available in ointment form

Are very effective broad-spectrum antibiotics.  They are bactericidal, destroying a wide spectrum of organisms that are often very difficult to treat.  Currently five are available:  ciprofloxacin (Ciloxan), gatifloxacin (Zymar), moxifloxacin (Vigamox), levofloxacin (Quixin), and ofloxaci (Ocuflox). Significant advers effects incl formation of corneal precipitates during treatment for bacterial keratitis.  Other rxn incl corneal staining and infiltrates. Those that occur are usually taste disorders and nausea.