NBEO Pharmacology & Ocular Disease Treatment 2 — Questions and Answers
Question 1: What medications are used to treat allergic conjunctivitis?
- Topical antihistamine/mast cell stabilizer combination drops (e.g., olopatadine, ketotifen) and cold compresses (Correct answer)
- Oral antibiotics
- Topical steroids as first line
- Pupil-dilating drops
Correct answer: Topical antihistamine/mast cell stabilizer combination drops (e.g., olopatadine, ketotifen) and cold compresses
Dual-action agents combining antihistamine (immediate relief) and mast cell stabilization (prevention) are first-line treatment. Artificial tears dilute allergens, and cool compresses reduce symptoms.
Question 2: What is the treatment for herpes simplex keratitis?
- Topical antiviral medication (trifluridine or ganciclovir gel) and possibly oral antiviral therapy; corticosteroids require careful management (Correct answer)
- Topical antibiotics only
- No treatment is needed
- Surgical removal of the cornea
Correct answer: Topical antiviral medication (trifluridine or ganciclovir gel) and possibly oral antiviral therapy; corticosteroids require careful management
HSV keratitis requires antiviral therapy. Topical antivirals treat epithelial disease. Stromal disease may require steroids (carefully, with antiviral cover) to reduce inflammation and prevent scarring.
Question 3: What are artificial tears and when are they prescribed?
- Lubricating eye drops that supplement the natural tear film, prescribed for dry eye disease, post-surgical care, and contact lens discomfort (Correct answer)
- Drops that increase tear production permanently
- Antibacterial eye drops
- Drops that dilate the pupil
Correct answer: Lubricating eye drops that supplement the natural tear film, prescribed for dry eye disease, post-surgical care, and contact lens discomfort
Artificial tears come in various formulations (preserved, preservative-free, lipid-based, gel) to supplement deficient tear film, reduce symptoms of dryness, and protect the ocular surface.
Question 4: What is the role of punctal plugs in dry eye treatment?
- Small devices inserted into the tear drainage openings to retain tears on the eye surface longer (Correct answer)
- Plugs inserted into the ear canal
- Devices used during surgery
- Contact lens accessories
Correct answer: Small devices inserted into the tear drainage openings to retain tears on the eye surface longer
Punctal plugs (silicone or collagen) block the tear drainage puncta, keeping natural and artificial tears on the ocular surface longer, increasing tear volume and reducing dry eye symptoms.
Question 5: What is the pharmacological treatment for acute angle-closure glaucoma?
- Emergency IOP reduction with topical beta-blockers, alpha-agonists, pilocarpine, and oral or IV acetazolamide, followed by laser iridotomy (Correct answer)
- Wait and observe without treatment
- Topical antibiotics only
- Warm compresses and rest
Correct answer: Emergency IOP reduction with topical beta-blockers, alpha-agonists, pilocarpine, and oral or IV acetazolamide, followed by laser iridotomy
Acute angle closure is an emergency requiring rapid IOP reduction using multiple agents simultaneously: timolol, apraclonidine, pilocarpine (to open the angle), and acetazolamide (to reduce aqueous production). Definitive treatment is laser iridotomy.
Question 6: What topical NSAIDs are used in optometric practice?
- Ketorolac, bromfenac, and nepafenac, used for post-surgical inflammation, seasonal allergic conjunctivitis, and pain management (Correct answer)
- NSAIDs are not available in eye drop form
- Only oral NSAIDs are used in eye care
- Topical NSAIDs are used only for glaucoma
Correct answer: Ketorolac, bromfenac, and nepafenac, used for post-surgical inflammation, seasonal allergic conjunctivitis, and pain management
Topical ophthalmic NSAIDs reduce prostaglandin-mediated inflammation and pain. They are commonly used after cataract surgery (to prevent macular edema), for seasonal allergy, and for post-refractive surgery pain.
NBEO Pharmacology & Ocular Disease Treatment 2
What medications are used to treat allergic conjunctivitis?