Polyvinyl alcohol pva propylene glycol povidone cmc

 Polyvinyl alcohol (PVA)
 Propylene glycol
 Povidone
 Carboxymethylcellulose (CMC)
 Ointments  enhanced retention time in the eye compared to artificial
tears

o Active ingredients
 White petroleum
 Mineral oil
 Lanolin
o S/E
 Blurred vision  reduce amount, administer before
bedtime
 hypersensitivity reactions  preservative-free/non-
medicated ointments
 irritation
o Dosing  BID  may increase if needed
 Gels--?enhanced retention time in the eye and more tolerated than
ointments
o Active ingredients
 Hydroxypropyl methylcellulose 0.3%-->GenTeal
 Carboxymethylcellulose 1%-->Theratears Gel
o Dosing  1-2 drops 3-4x/day PRN
 Allergic Conjunctivitis
o Non-pharmacological
 Avoiding known triggers
 Cool compresses
 Keep doors & windows closed
 Running AC
 Using air filters
 Avoid wearing contacts
 Wearing sunglasses outside
o Pharmacological
 1 st line  artificial tears
 2 nd line  topical antihistamines/mast cell stabilizers
 MOA: antagonizes H1 receptors and stabilizes mast cells to reduce
inflammation and allergic reactions
 Ex: 0.025% ketotifen fumarate  Zaditor or Alaway
 Dosing  1 drop BID every 8-12 hours
 Other therapies  topical decongestants, astringents, or oral antihistamines
 MOA: causes potent vasoconstriction in the eye to reduce redness
 Active ingredients:
o Phenylephrine
o Naphazoline
o Tetrahydrozoline
o Oxymetazoline
 S/E: rebound congestion (if used over 72 hours)
 Dosing  1-2 drops up to 4x/day PRN
 Decongestants Contraindications
o Pt has angle-closure glaucoma

o Use over 3 days
o Naphazoline and tetrahydrozoline less likely to cause rebound 
preferred
 Combination antihistamine/decongestant
o Pheniramine w/ naphazoline
 Naphcon-A
 Opcon-A
 Visine-A
 Combination Decongestant/Astringents
o C: Zinc sulfate  contraction of eye tissue  decrease
bleeding/danage
o w/ naphazoline  Clear Eyes ACR
o w/phenylephrine  Zincfrin
 Corneal Edema
o Non-pharmacological
o Pharmacological
 Hyperosmotic Agents
 MOA: increase tonicity near the tear film resulting in movement of fluid
from cornea to tear film
 Products:
o Sodium Chloride 2% or 5%--> as solutions or ointments  Muro
128
 Dosing  1-2 gtts q3-4h (ointments less frequent and applied at night)
 1 st line  NaCl 2% sln
 2 nd line  NaCl 5% ointment
 3 rd line  NaCl 5 % solution
o Contraindications
 Compromised or damaged corneal epithelium
 Loose foreign Object
o Pharmacological
 Ocular Irritants
 MOA: cleanses surface of the eye and washes away foreign particles
 Active ingredients:
o Sodium Chloride
o Sodium Borate
o Sodium Phosphate
o Potassium Chloride
