Question 1

What medication may interact with ophthalmic vasoconstrictors,inducing a side effect of an increase in intraocular pressure (IOP)?

Accepted Answer

Monoamine oxidase inhibitors (MAOIs) may interact with ophthalmic vasoconstrictors and induce an increase in intraocular pressure (IOP). MAOIs inhibit the breakdown of certain neurotransmitters, including norepinephrine, which is involved in the regulation of the eye's intraocular pressure. When used concurrently with ophthalmic vasoconstrictors, MAOIs can cause a buildup of norepinephrine, leading to an increase in IOP. This can be dangerous for patients with glaucoma or other eye conditions that are sensitive to changes in IOP.

Question 2

What is the best definition of a hordeolum?

Accepted Answer

A hordeolum, also known as a stye, is an infection of the sebaceous gland of the eyelash. It usually appears as a red, painful bump on the eyelid.

Question 3

What is the mechanism of action of an ophthalmic topical anesthetic agent?

Accepted Answer

Ophthalmic topical anesthetics work locally by blocking initiation and conduction of nerve impulses in the cornea and conjunctiva. They decrease the neuronal membrane's sensitivity to sodium ions, thereby decreasing the sensation of pain. This mechanism of action is achieved by blocking the voltage-gated sodium channels in the nerve membrane.

Question 4

Patients who frequently use tetrahydrozoline for temporary relief of eye redness may experience what adverse reaction?

Accepted Answer

Overuse of tetrahydrozoline can cause "rebound" congestion, where the user experiences worsening of redness and irritation as the medication wears off, leading to continued and prolonged use. This can result in dependence on the medication and further adverse effects.

Question 5

Contact lens users are at greater risk for which type of ophthalmic infection?

Accepted Answer

The answer of Contact lens users are at greater risk...

Question 6

What health-care education should be given to a geriatric patient who is using a sulfacetamide solution for his left eye that was prescribed 2 months ago?

Accepted Answer

Sulfacetamide solution may lose its potency over time or if it has been exposed to certain environmental conditions. If the solution has turned a dark color, it may indicate a decrease in its effectiveness and should be disposed of properly. It is important to follow the medication label instructions and the healthcare provider's advice regarding the proper use of the medication for the left eye only. Cleaning the left eye before application may enhance the drug's therapeutic effect, and consecutively applying it to the right eye without a healthcare provider's recommendation may lead to inappropriate use and potential harm. If the left eye has become irritated or shows other side effects, the healthcare provider should be consulted before making any decisions about continuing treatment.

Question 7

Which ophthalmic preparation inhibits the enzymatic destruction of acetylcholine by deactivating cholinesterase and permitting acetylcholine to continue a short-term state of induced miosis?

Accepted Answer

The answer of Which ophthalmic preparation inhibits the enzymatic destruction...

Question 8

Miotic ophthalmic preparations used to treat glaucoma cause iris sphincter muscle contraction,resulting in constriction of the pupil.By what mechanism does this decrease IOP?

Accepted Answer

Constriction of the pupil caused by miotic ophthalmic preparations leads to a pulling effect on the trabecular meshwork which in turn opens the canal of Schlemm. This results in an increased outflow of the aqueous humor, thereby decreasing intraocular pressure.

Question 9

A patient suffering from dry eyes was prescribed Refresh Lacri-Lube Eye Ointment 3 weeks ago.She visits your office with continued complaints of eye dryness despite daily use of the ointment.Assuming that no other underlying condition is responsible for her symptoms,what important health history information is most likely responsible for the ineffectiveness of the ointment?

Accepted Answer

The timing of application is important as the ointment can cause blurred vision, and it is recommended to apply it at bedtime to allow it to remain in the eye for longer. Applying it in the morning would not be as effective in treating dry eyes. Warming the solution or cleaning the tip of the applicator would not affect the effectiveness of the ointment, and closing the eyes for 10 minutes after application can actually improve its effectiveness.

Question 10

Sulfacetamide is incompatible with any other ophthalmic drops that contain which agent?

Accepted Answer

Sulfacetamide is incompatible with thiomersal, a mercury-containing preservative that is used in various ophthalmic drops. This can lead to precipitation and decreased efficacy of both drugs. Therefore, thiomersal-containing drops should not be used concomitantly with sulfacetamide drops.

Question 11

A mother accompanies her 6-year-old daughter for an office visit.The young girl is diagnosed with Streptococcus pneumoniae conjunctivitis.The mother asks how she can prevent the girl's 3- and 8-year-old siblings from "catching" the eye infection.What advice is least likely to help the mother and her children?

Accepted Answer

Sharing a bed with someone who has an eye infection can increase the risk of transmission. Therefore, the children should not share beds at nighttime. Choices A, B, and C are all good measures to prevent the spread of infection.

Question 12

A patient currently using an ophthalmic mast cell stabilizer for an allergic eye disorder continues to complain of unremitting symptoms despite 4 weeks of therapy.What disease entity must be excluded?

Accepted Answer

The patient's continued symptoms despite mast cell stabilizer use suggest that the underlying cause may not be allergy-related. Herpes keratitis is a viral infection that can present with symptoms similar to allergic eye disorders, and can be exacerbated by the use of mast cell stabilizers. It is important to exclude this possibility with further evaluation and diagnostic testing. Acute open-angle glaucoma and gonococcal keratitis typically present with more severe symptoms such as eye pain, redness, and decreased vision, and would usually require urgent intervention. Macular degeneration is a chronic condition that can cause gradual loss of central vision, but is not typically associated with allergy-related symptoms.

Question 13

By what mechanism does cyclosporine (Restasis Ophthalmic)prevent corneal transplant rejection?

Accepted Answer

Cyclosporine inhibits the activity of calcineurin, which is required for T-cell activation and proliferation. By inhibiting T-cell activity, cyclosporine can prevent rejection of a corneal transplant, which is mediated by the immune system's response to the transplanted tissue. Cyclosporine does not exclusively inhibit cellular or humoral immune responses, and it does not target B-cells specifically.

Question 14

What is vernal conjunctivitis?

Accepted Answer

Vernal conjunctivitis is a long-term swelling of the outer lining of the eyes that is caused by an allergy, typically seasonal. It usually affects children and young adults, and symptoms can include itchiness, redness, watering, and discharge from the eyes. Treatment may involve the use of antihistamines or other allergy medications, as well as avoiding allergens when possible.

Quiz 5: Drugs Used in the Treatment of Eye and Ear Disorders

What medication may interact with ophthalmic vasoconstrictors,inducing a side effect of an increase in intraocular pressure (IOP) ?