Drugs used in ophthalmology. Ophthalmic drugs

Eye drops are used in ophthalmological practice for the prevention and treatment of diseases of the anterior segment of the eye, outer membranes and eyelids. Such products can have different effects on the eyes; they contain one or more components.

Immediately before instilling the drops, the bottle of medicine should be warmed in your hand to body temperature. The procedure should be carried out in a calm environment, after washing your hands. In order for the drop to get to the right place, you should tilt your head back and pull down your lower eyelid. To avoid getting the medicinal solution into the nasal cavity, after instillation, close your eye and press on the inner corner.

An important feature of medicinal eye medications is that they quickly penetrate through the outer mucous membrane of the eye into the deeper parts of the visual apparatus. It is not permissible to use such means on your own. Before starting treatment, it is important to read the instructions.

So, how to put eye drops for various diseases and what kind of eye drops are there in general?

Types of eye drops

Let's look at the list of eye medications depending on their pharmacological action:

Antimicrobial. They include antibiotics, as well as antiviral, antiseptic and antimycotic drugs;
Anti-inflammatory.
Antiglaucoma. They are divided into drugs that improve the outflow of ocular fluid and inhibit the production of aqueous fluid.
Drugs that improve tissue metabolism.
Antiallergic.
Medicines for the treatment of cataracts.
Moisturizing.
Diagnostic.

The best eye drops can be prescribed by a specialist, as he understands the composition and pharmacological action of the drug

The best eye drops

Next, we’ll talk about what effective remedies there are in the fight against various types of ophthalmological disorders. You can choose the best drops only after a detailed review and comparative analysis.

Moisturizing

This group of drugs is used for tired and dry eyes. Experts recommend using moisturizers for dry eye syndrome, prolonged use of the computer, and exposure to adverse environmental factors. Such medications are sold without a prescription form, so they can be freely purchased in pharmacy chains.

Moisturizing drops do not affect the tissues of the eye, but are artificial tears. Thanks to this, they have virtually no contraindications. Let's consider popular products from the group of moisturizing drugs:

Visomitin. The product has a keratoprotective effect, it fights age-related changes in tear fluid, as well as dry eye syndrome. Visomitin has antioxidant activity, which normalizes conjunctival cells, relieves the inflammatory reaction and normalizes the composition of the tear film. Visomitin is drops for cutting, itching, burning and pain in the eyes. This is a unique drug that affects not only the symptoms, but also the very cause of the problem.
Systane. The relaxing drug effectively eliminates dryness, fatigue and irritation of the eyes. Soon after instillation, unpleasant symptoms such as itching, redness, and burning decrease. When the drops fall on the mucous membrane of the eye, they form a film that protects against drying out.
Vidisik. The gel has keratoprotective properties. This is a combined remedy, similar in composition to tear fluid. Vidisik forms a delicate film on the surface of the eye that lubricates and moisturizes. The gel stimulates healing processes.
Hilo chest of drawers. These are drops for relaxing the eyes, which are used for dry eye syndrome, after surgery, and also for feeling comfortable when wearing contact lenses. Hilo-komod contains hyaluronic acid, it does not contain any preservatives and is approved for use during pregnancy. Hilo-chest of drawers are drops for pain, itching and fatigue in the eyes.

Systane is a well-known eye drop for irritation

Activating metabolic processes

Experts prescribe such drops to slow down age-related changes and degenerative processes in the tissues of the visual apparatus, as well as in the treatment of cataracts. The active components included in the composition help the eye receive more oxygen and nutritional components. Medicines in this group improve microcirculation processes, nutrition of the eye and restore functional activity.

Let us highlight the prominent representatives of this group:

Quinax. Often prescribed for the treatment of lens opacity - cataracts. Quinax has antioxidant activity and protects the lens from the negative effects of free radicals.
Taufon. The drug is prescribed for dystrophic changes occurring in the organs of vision. Taufon stimulates metabolic and energy processes, and also accelerates healing processes. The product normalizes intraocular pressure and metabolism.
Catalin. It is used for preventive and therapeutic purposes against diabetic and senile cataracts. Catalin normalizes nutrition, metabolic processes in the lens, and also prevents the appearance and development of cataract symptoms.

Taufon are cheap eye drops that activate metabolic processes in the tissues of the eye.

Antiglaucoma

Antiglaucoma drops are prescribed for increased intraocular pressure. Glaucoma, or eye hypertension, is fraught with the development of atrophic changes in the optic nerve and complete loss of vision. The drugs reduce the production of intraocular fluid and improve its outflow. Such drops are a good method of non-surgical treatment of glaucoma. The preservation of the patient’s vision depends on the correctness of their choice.

Let's talk about four well-known anti-glaucoma drops:

Pilocarpine. The drug constricts the pupil of the eye and reduces increased intraocular pressure. Pilocarpine is also used during eye examinations, as well as after surgical interventions. The product belongs to the group of alkaloids, which is made from the leaves of a plant of the genus Pilocarpus;
Betoptik. The drug belongs to the group of selective beta-blockers. Intraocular pressure is reduced by reducing the production of ocular fluid. Betoptik selectively affects the receptors of the visual apparatus. The product does not affect pupil size and twilight vision;
Fotil. These are combined drops that contain pilocarpine and timolol, a beta-blocker. Fotil causes a spasm of accommodation and constriction of the pupil. Already half an hour after instillation, an effect is observed that can last up to fourteen hours;
Xalatan. The product improves the outflow of aqueous humor, preventing the progression of glaucoma.

Eye wash drops

Eye rinsing may be necessary in case of injury, as well as exposure to a foreign body or aggressive substances. Doctors also recommend the procedure for inflammatory processes. Let's look at three types of eye wash drops:

Sulfacyl. Belongs to the group of sulfonamides. It has a bacteriostatic effect on gram-positive and gram-negative microflora. This means that under the influence of the drug, the active growth and reproduction of pathogens is suspended;
Levomycetin. This is an antibiotic with a wide spectrum of action. Accustoming to Levomycetin occurs slowly.
Albucid. This is an antibiotic with a bacteriostatic effect that eliminates infectious and inflammatory processes. The active substance has antimicrobial activity and belongs to sulfonamides.

Albucid are antibacterial drops that are used to wash the eyes

Midriatics

The pupil is a hole in the iris of the eye through which sunlight enters and is refracted onto the retina. Drops to dilate the pupil can be used in two cases:

Therapeutic purpose. In the treatment of inflammatory processes and during surgery.
Diagnostic purpose. To check the fundus of the eye.

Let's review the famous mydriatics:

Atropine. The product has a large number of contraindications and is highly toxic. Sometimes the effect of Atropine lasts for ten days. The drug can cause discomfort and blurred vision for a certain period of time;
Mydriacyl. Approximately twenty minutes after instillation, the product begins to act. The therapeutic activity is maintained for several hours, which means the functions of the eye are quickly restored. The product can be used by both adults and children. You can read more about eye drops for children;
Irifrin. The product is used for both medicinal and diagnostic purposes. This is due to Irifrin’s ability to lower intraocular pressure.

Irifrin is used for diagnostic purposes to dilate the pupil.

Antiseptic

The main task of antiseptics is to disinfect surfaces. These agents have a wide spectrum of action and therefore bacteria, viruses, protozoa, and fungi are sensitive to them. They are low-allergenic and do not have a systemic effect on the body. The drugs help alleviate the condition of conjunctivitis, keratitis, uveitis and other inflammatory processes. Antiseptics eliminate redness and prevent the effects of pathogens.

Let's consider two well-known antiseptics for the treatment of eye diseases:

Vitabact. Drops have a wide spectrum of antimicrobial action. Piloxidin is the main active component of the drug. Vitabact is used for infectious lesions of the anterior parts of the eye: conjunctivitis, dacryocystitis, keratitis, blepharitis.
Okomistin. Benzyldimethyl is the active ingredient in antiseptic drops. Okomistin is prescribed for eye injuries, keratitis, conjunctivitis. It is also used to prevent purulent-inflammatory complications.

Okomistin is an antiseptic drop for eyes and ears.

Antiallergic

This group of drugs is used for allergic manifestations in the eye area:

redness;
edema;
burning;
photophobia;
lacrimation.

The peculiarity of antiallergic drops is that they only relieve allergy symptoms, but do not have a therapeutic effect. Such drugs are prescribed for seasonal conjunctivitis, inflammation of the conjunctiva caused by wearing contact lenses, as well as drug-induced inflammation.

Consider the list of antiallergic drops:

Alomide. It is an antihistamine used to stabilize mast cells. After instillation, temporary itching, burning and tingling may occur.
Allergodil. The product has an anti-edematous and anti-allergic agent. Allergodil is used for seasonal conjunctivitis, as well as year-round inflammation of an allergic nature. It is allowed to use the product after twelve years. Allergodil may cause eye irritation.
Opatanol. The active component of the drops is a potent selective antihistamine. Opatanol effectively fights the symptoms of seasonal conjunctivitis: itching, burning, swelling, redness of the mucous membrane.
Dexamethasone and Hydrocortisone are used strictly as prescribed by the doctor. Dexamethasone is a corticosteroid that relieves inflammation and allergic reactions. Hydrocortisone relieves inflammation, irritation, redness, and also reduces the migration of protective cells at the site of the inflammatory reaction.

Allergodil is an antiallergic drug that is used in the form of eye drops and nasal spray.

Vasoconstrictors

Such remedies are used for swelling and redness of the eye. Such unpleasant sensations may be the result of an allergic, inflammatory reaction or irritation. Constriction of blood vessels leads to swelling and swelling disappearing within just a few minutes. You can use vasoconstrictor drugs strictly as directed by a doctor and for a short time, as they can be addictive.

Let's take a closer look at the representatives of the vasoconstrictor group:

Octilia. The drug belongs to alpha-adrenergic agonists. Tetrizoline, the active component of Octilia, constricts blood vessels, relieves swelling, stimulates the outflow of intraocular fluid and causes pupil dilation. The product relieves unpleasant symptoms of eye irritation: lacrimation, itching, burning, pain;
Okumetil. This is a combined anti-inflammatory agent with antiallergic and antiseptic effects. Okumetil relieves swelling and irritation of the eye. After installation, the active component is able to be absorbed into the systemic bloodstream, which can cause serious side effects from internal organs;
Visine. The active component is an alpha-adrenergic agonist - tetrizoline. Visine constricts blood vessels and relieves swelling. Within a minute, the effect of the drug appears, which lasts for four to eight hours.

Visin eye drops quickly constrict blood vessels

Antibacterial

Antibacterial drugs fight bacterial eye diseases. But it is a bacterial infection that most often becomes the cause of inflammatory processes. Let's talk about effective antibiotics in the form of drops:

Tobrex. The active component of the drug is tobramycin. This is an antibiotic from the aminoglycoside group. Tobrex is used to treat infectious and inflammatory processes in people of any age, including newborns. Staphylococci, streptococci, Klebsiella, Escherichia coli and diphtheria coli are sensitive to tobramycin;
Digital The active ingredient is ciprofloxacin, an antibiotic from the fluoroquinolone group. Can cause adverse reactions in the form of allergic reactions;
Phloxal. This is an antimicrobial drug to which gram-negative bacteria are most sensitive. Floxal is effective in the treatment of styes, conjunctivitis, blepharitis, keratitis and other diseases.

Antiviral

There are two types of antiviral drops:

Virucidal chemotherapy drugs and interferons. These drugs destroy the viral infection.
Immunomodulators. Strengthen the resistance, or resistance, of the body, making it easier for it to fight pathogens.

Poludan is an effective antiviral agent

Let's talk about four popular antiviral eye drops:

Oftan I'm coming. Idoxuridine is the active component of the drug, which is a pyrimidine nucleotide. Its main disadvantage is poor penetration into the cornea and the inability to affect resistant strains of viruses and toxic substances. When Oftan Ida is instilled, itching, burning, pain, and swelling may occur;
Oftalmoferon. This is a combination drug that has anti-inflammatory, antiviral and immunomodulatory properties. The product is made based on human recombinant interferon. Ophthalmoferon also has local anesthetic and regenerative effects;
Aktipol. The product not only has an antiviral effect, it has antioxidant, radioprotective and regenerative properties. Aktipol is quickly absorbed into the eye tissue and promotes wound healing, as well as relieving swelling;
Poludan. Typically, drops are used in the treatment of adenoviral and herpetic lesions of the eye. Poludan also has an immunomodulatory effect. Sometimes the product can cause allergic side effects.

So, eye drops are effective drugs in the fight against various diseases of the visual system. These products are divided into different groups depending on the presence of the active ingredient. For bacterial lesions, antibacterial agents are used, but if the ophthalmological disorder is viral in nature, then specialists prescribe antiviral drops. In case of a fungal disease, antimycotic drops are prescribed. And this is not a complete list of all available eye medications.

Eye drops can be used not only for medicinal purposes, they are also used for prevention and diagnostic testing. Be that as it may, medications for the eyes should be prescribed by a doctor after an examination and an accurate diagnosis.

Among the many dosage forms used in ophthalmology, the most interesting are eye drops, ointments, films and contact lenses containing medicinal substances.

Eye films (membranulae ophtalmicae seu lamellae) have a number of advantages over other ophthalmic drugs: with their help, it is possible to prolong the action and increase the concentration of the drug in the tissues of the eye, and reduce the number of injections from 5 - 8 to 1 - 2 times a day. They are placed in the conjunctival sac (Fig. 2.1), within 10 - 15 seconds they are moistened with tear fluid and become elastic. After 20 - 30 minutes, the film turns into a viscous polymer clot, which after approximately 90 minutes completely dissolves, creating a thin, uniform film. At the moment, the most modern are Apilak eye films.

Rice. 2.1. Laying the eye film

Eye medicinal films Apilak (Membranulae ophthalmicae cum Apilaco) are oval-shaped polymer plates of yellow or brownish-yellow color (9 mm long, 4.5 mm wide, 0.35 mm thick). The active substance is royal jelly (a waste product of bees). They are used as a wound-healing and antibacterial agent for traumatic keratitis and damage to the cornea.

Eye drops are the most commonly purchased dosage form in ophthalmology. Among modern drugs in the form of eye drops, the following are most in demand and promising: Systeine Ultra, Fotil, Allergodil, Visomitin.

Systane Ultra (Fig. 2.2) is a moisturizing ophthalmic solution to eliminate irritation and dryness of the cornea caused by external or internal adverse factors, including wearing contact lenses.

Systane Ultra sterile ophthalmic drops contain:

§ Polyethylene glycol - 0.4%;
§ Propylene glycol - 0.3%;
§ Sodium chloride - 0.1%;
§ Boric acid - 0.7%;
§ Hydroxypropyl guar - 0.16-0.19%;
§ Potassium chloride - 0.12%;
§ 2-amino-2-methylpropanol - 0.57%;
§ Sorbitol - 1.4%;
§ Polyquad - 0.001%;
§ Purified water and sodium hydroxide or hydrochloric acid (to stabilize the pH).

Visomitin is a drug with a fundamentally new approach to the treatment of eye diseases. Mainly used as a keratoprotector to treat age-related changes in the lacrimal gland, dry eye syndrome, and computer syndrome. At the same time, due to the antioxidant activity of the drug, the functions of tear-producing cells of the conjunctiva are normalized, inflammation is relieved (manifested by redness of the eyes, a feeling of dryness and a foreign body), and the composition of the tear film is normalized.

Compound. Active substance: plastoqbromide (PDTP) 0.155 mcg. Excipients: benzalkonium chloride 0.1 mg, hypromellose 2 mg, sodium chloride 9 mg, sodium dihydrogen phosphate 0.81 mg, sodium hydrogen phosphate dodecahydrate 116.35 mg, sodium hydroxide 1 M solution to pH 6.3 - 7.3, water for injections up to 1 ml.

Rice. 2.2. Systane ultra eye drops

Fotil is a combined antiglaucoma drug (Fig. 2.3). Active substances - pilocarpine hydrochloride, timolol maleate.

Rice. 2.3. Fotil eye drops

Eye drops 0.05% Allergodil is an antiallergic drug used for allergic conjunctivitis. Active substance - azelastine hydrochloride

Among eye ointments, the most relevant at the moment is blepharogel 1 and 2 (Fig. 2.4). Active ingredients of Blepharogel 1 - Hyaluronic acid, Aloe Vera extract. It is used for dry eye syndrome and blepharitis of various etiologies.

Blefarogel 2 contains hyaluronic acid, Aloe Vera extract, sulfur. It is used for demodicosis of the eyelids, blepharitis and dry eye syndrome.

Rice. 2.4. Blepharogel

At the moment, developed contact lenses capable of gradually releasing drugs are promising. They consist of two polymers already used in ophthalmology. The inner layer of the lens, which breaks down with use, consists of polylactic glycolic acid, and the outer layer is made of polyhydroxyethyl methacrylate. These lenses may contain the following medicinal substances - corticosteroids, taurine, vitamins. These contact lenses can replace the constant use of eye drops for conditions such as glaucoma and dry eye syndrome.

Rice. 2.5. Contact lenses containing glaucoma medication

Hydrogel contact lenses (Fig. 2.5) are coated with a shape-memory biogel (multi-colored spheres, right), which contains a drug for glaucoma (red). The gel consists of nano-sized diamonds coated with polyethyleneimine (green), which are cross-linked with chitosan (gray). When lysozyme, an enzyme found in tears, breaks down chitosan, the gel breaks down and slowly releases the drug over a 24 hour period.

Moisturizing and astringent eye products (artificial tear preparations). Dry eye syndrome, or keratoconjunctivitis sicca, develops as a result of a number of different eye diseases, as well as systemic diseases (Mikulicz syndrome, Sjogren's syndrome, rheumatoid arthritis). In addition, impaired tear secretion is observed with increasing age and as a result of the influence of exogenous factors on tear secretion.

For dry eye syndrome, symptomatic therapy is carried out, which is mainly based on replenishing the missing amount of tear fluid. Aqueous solutions of various viscosities or gel-like tear film substitutes with high viscosity are used as artificial tears.

Substances that can increase viscosity include semi-synthetic cellulose derivatives in concentrations from 0.5% to 1% (methyl cellulose, hydroxypropyl methyl cellulose, hydroxyethyl cellulose), polyvinyl glycol, polyvinylpyrrolidone, polyacrylic acid derivatives, 0.9% dextran solution , carbomer 974R.

Tear substitutes are used not only for dry eye syndrome, but also for abnormal eyelid position (lagophthalmos, eyelid inversion). These drugs are not recommended for use in infectious diseases of the eyelids, conjunctiva and cornea. The frequency of use is determined individually.

Stimulators of corneal regeneration. In case of diseases of the cornea with a violation of its integrity, injuries and burns of the eye, it is necessary to accelerate its regeneration. For this purpose, drugs such as 10% methyluracil ointment, solcoseryl, corn-nereel, as well as drugs containing glycosaminoglycans isolated from the cornea of various animals (for example, adgelon) are used. In addition, antioxidants have a stimulating effect on regenerative processes: yeast cytochrome C (0.25% eye drops) and erisod.

Drugs of this group are used in complex therapy of radiation, thermal, chemical burns of the conjunctiva and cornea, injuries of the anterior part of the eye, erosive and dystrophic keratitis. Typically, these drugs are used 3-6 times a day.

Drugs that have fibrinolytic and antioxidant effects. Many eye diseases are accompanied by the development of hemorrhagic and fibrinoid syndromes. Various fibrinolytic drugs are used to treat them.

The most widely used enzymatic preparations are a prolonged analogue of streptokinase - streptodecase and urokinase. In the treatment of intraocular hemorrhages of various origins and dyscirculatory disorders in the vessels of the retina, these drugs are administered parabulbarly at 0.3-0.5 ml (30,000-45,000 FU). In addition, streptodecase can be used in the form of ophthalmic medicinal films.

The Russian Cardiological Research and Production Complex of the Ministry of Health of the Russian Federation has developed a hemazalophilized powder in ampoules of 5000 units, which contains recombinant prourokinase. The drug has a pronounced fibrinolytic effect; it is administered parabulbarly and subconjunctivally.

Of great interest are domestic drugs that, in addition to fibrinolytic, have antioxidant and retinoprotective effects - emoxipine and histochrome.

Emoxipin(Emoxipin) has long been successfully used to treat various eye diseases. It has an antioxidant effect, stabilizes the cell membrane, inhibits platelet and neutrophil aggregation, has fibrinolytic activity, increases the content of cyclic nucleotides in tissues, and reduces the permeability of the vascular wall. Emoxipine, having a retinoprotective effect, also protects the retina from the damaging effects of high-intensity light.

The drug is used for the treatment of intraocular hemorrhages of various origins, angioretinopathy (including diabetic retinopathy); chorioretinal dystrophies, thrombosis of the central retinal vein and its branches, complicated myopia. In addition, it is used for the treatment and prevention of damage to eye tissue by high-intensity light (sun rays, laser radiation or laser coagulation); in the postoperative period in patients with glaucoma, with choroidal detachment; for dystrophic diseases of the cornea; injuries and burns of the cornea.

The drug is used in the form of a 1% solution for injection and eye drops. Emoxypine solution is administered subconjunctivally and parabulbarly, and, if necessary, retrobulbarly. Subconjunctivally, 0.2-0.5 ml (2-5 mg) is administered, parabulbar - 0.5-1 ml (5-1 mg) of a 1% solution. The drug is used once a day or every other day for 10-30 days. If necessary, treatment can be repeated 2-3 times a year. 0.5-1 ml of a 1% solution of the drug is administered retrobulbarly once a day for 10-15 days.

Histochrome(Hystochrom) - a preparation containing echinochrome (quinoid pigment of marine invertebrates). Histochrome acts as an “interceptor” of free radicals formed during lipid peroxidation. In addition to antioxidant, the drug has retinoprotective and bactericidal effects. Histochrome is used in the form of a 0.02% solution (in ampoules of 1 ml). The drug is administered subconjunctivally and parabulbarly in the treatment of hemorrhagic and fibrinoid syndromes.

For a long time, diseases of the organs of vision were treated using medications intended for use in the treatment of internal diseases. The nineteenth century was marked by a large number of discoveries that were associated with the discovery of a huge number of organic compounds in plants.

Later they began to be used in the treatment of ophthalmic diseases. For example, in 1832, the medicinal plant Atropa Belladonna (Delladonna belladonna, Solanaceae family) was isolated, which immediately found use among ophthalmologists. In 1875, pilocarpine was isolated; and already in 1877 it was experimentally established that it perfectly lowers intraocular pressure. As a result, it began to be used as a treatment for glaucoma. It is worth noting that he is still not losing ground in modern ophthalmology.

Antimicrobials

Today, many local drugs of different composition and dosage forms are produced for use in ophthalmic practice.

These include :

Bacitracin - erythromycin
- chloramphenicol (chloramphenicol) - gentamicin
- chlortetracycline - norfloxacin
- ciprofloxacin - ofloxacin
- sulfacetamide - sulfafurazole
- polymyxin B - tetracycline
- tobramine

When choosing a drug, you should be guided at least by the results of a medical examination, and ideally also by the results of bacterial culture for antibiotic sensitivity. Complex ophthalmic infections, for example, endophthalmitis and corneal ulcers, are treated using drugs manufactured directly in industrial pharmacies. To do this, the pharmacist needs to know their time parameters for processing in the sterilizer.

Use of drugs

Infections of the skin, lacrimal organs, eyelids and conjunctiva are very widely known in medical practice. Each patient has his own treatment tactics, depending on his specific clinical picture.

Damage to the nasolacrimal duct of an inflammatory or purulent-inflammatory nature. It occurs in both children (more often) and adults. In infants, it is most often associated with obstruction of the duct. In adults, dacryocystitis, as well as dacryocanaliculitis, can be caused by: staphylococci, actinomycetes, fungi of the genus Candida, and actinomycetes.

Characteristic inflammations of the eyelids are, as well as. With barley, the sebaceous (meibomin) and/or Moll glands located at the edges of the eyelids become inflamed. The most common cause is Staphylococcus aureus; in this case, it is prescribed to apply compresses and put antibacterial ointment behind the eyelid. For example, a warming compress and floxal ointment. Blepharitis is a common recurrent inflammation of the ciliary edge of the eyelids, characterized by burning and inflammation, sometimes accompanied by peeling. The most common cause is also staphylococci. The basis of therapy is - eye washing; Often, antibacterial ointments are also used topically in combination with drops, in case of keratitis or conjunctivitis. For example, Okomistin drops will be effective for washing the eyes. You can also use strained warm chamomile decoction or the well-known sleepy black tea for rinsing. And as the main treatment, Tobrex (tobramycin) eye drops, which have both adult and pediatric dosage forms, as well as tetracycline eye ointment, are well suited. Doctors often make up various combinations of the above medications.

This is an inflammation of the lining part of the eyelid and covering the whites of the eyes, a membrane of cylindrical epithelium of varying severity: from simple redness to a severe purulent process. It can be of various origins: bacterial, allergic, viral. In addition, contact lenses, the general condition of the body and immune system, chemical and air pollutants also play a role. Atypical bacterial conjunctivitis is treated empirically.

Endophthalmitis is an acute abscessive inflammation of the eyeball. If inflammation covers all the membranes of the eyeball, this is called panophthalmitis. Endophthalmitis can be caused by fungi, bacteria, and much less commonly, spirochetes. It can occur after surgery on the eyes, after injuries, in patients with weak immunity. Therapy consists of surgery - vitreectomy and antimicrobial therapy, in which the drug is injected directly into the vitreous body.

Antiviral agents

These include :

Idoxuridine - trifluridine
- vidarabine -
- foscarnet - ganciclovir
- fomivirsen - cidofovir

Application

The above medications are prescribed for the treatment of viral keratitis and retinitis, as well as herpes zoster in the ocular form. There is no effective drug to treat inflammation caused by adenovirus, but it usually goes away on its own.

Viral keratitis is a corneal disease that affects the epithelium or stroma. Most often, it is caused by herpes simplex virus (HSV) type 1. Less commonly - HSV type 2, cytomegalovirus and Epstein-Barr virus. Local antiviral agents will be effective for treatment, for example: Zovirax, acyclovir, Oftan Idu, Zirgan. Glucocorticoids stimulate viral replication, therefore drugs of this group are contraindicated for epithelial keratitis of herpetic nature. However, on the contrary, they are recommended in the complex treatment of stromal keratitis.

Herpes zoster in the ocular form is a reactivation of the varicella-zoster virus (VZV), which settles in the trigeminal ganglia. But the severity and possibility of aggravating the infection with complications is reduced if acyclovir is used systemically.

Application

- There are several effective regimens for the treatment of toxoplasmosis.:

1) trimethoprim and/or sulfamethoxazole in combination with clindamycin or without using it,
2) clindamycin, pyrimethamine, clindamycin, calcium folinate, sulfadiazine.
3) monotherapy with clindamycin.
4) pyrimethamine, sulfadiazine, calcium folinate. In parallel, systemic treatment with glucocorticoids, for example prednisolone, is carried out

Finally

Thus, for any eye disease, there is one or several effective treatment regimens that are widely used not only in the Russian Federation, but also abroad. In some cases, it is necessary to resort to surgical intervention. However, as with any other disease, timely consultation with a doctor, as well as the correct use of medications, can shorten its duration and help avoid complications.

Ophthalmic drugs occupy a special place among the wide range of drugs of modern medicine, and their production is the subject of independent consideration of pharmaceutical technology.

Firstly, this is explained by the unique characteristics of the organ of vision, which consist not only in the unique structure and properties, but also in the specific mechanisms of absorption and distribution of drugs, and the peculiarities of their interaction with the tissues and fluids of the eye. The mucous membrane of the eyes is very sensitive. She reacts sharply to all irritations. Therefore, when preparing medications for eye treatment, its anatomical, physiological and other features should be taken into account.

Secondly, the requirements for ophthalmic drugs have increased significantly. In modern pharmacopoeias and technical documentation of different countries, the same requirements are imposed on drugs as on injection solutions: they must be as clean as possible from mechanical and microbial contaminants, have an accurate concentration of substances, be isotonic, sterile and stable, and in some cases have a prolonged effect and buffer properties.

Thirdly, ophthalmic drugs combine both different types of dispersed systems and a wide range of drugs. Medicines used in ophthalmological practice can be divided into: 1) causal (etiological), destroying the cause of the disease, for example, antibacterial; 2) antipathogenetic, normalizing a certain link in the pathogenetic chain, for example, reducing the biosynthesis of histamine in allergic diseases; 3) anti-symptomatic - destroying or slowing down the intensity of the symptoms of the disease and thereby interrupting the state of a “vicious circle”, for example, pain, contraction of blood vessels. The essence of the pharmacological action is the combination of drugs with a pharmacoreceptor, i.e. a reactive chemical group of one of the components of a cell or extracellular substance (chemical mechanism), or a change in physicochemical properties or cell space (physicochemical mechanism).

Fourthly, the peculiarities of the anatomical structure of the organ of vision provide great opportunities for the local use of drugs.

This applies to the treatment of diseases of the auxiliary organs of vision and their anterior part. At the same time, there are certain conditions for the direct action of medicinal substances on the pathological focus. Different concentrations of medicinal substances are used, as well as different methods of their use: instillation of solutions, introduction of ointments, eye films, tablets, lamellas into the conjunctival sac, shading and dusting of the surface of the cornea or conjunctiva, introduction of solutions of medicinal substances intracorneal, retrobulbar into the Tenon space with using electrophoresis. The technique of endonasal electrophoresis (administration of medicinal substances through the nasal mucosa) is also used. Local therapy is the basis of pharmacotherapy for eye diseases, and is often the only possible method of treatment.

The peculiarities of the production of ophthalmic drugs should also include the problem of creating polymer packaging that would ensure their sterility and chemically unchanged state for a long time, and at the time of use - rapid sterile administration. Packaging should be simple, convenient, aesthetic, informative and economical.

Among ophthalmic dosage forms, eye drops and lotions, ointments, powders, and, more recently, eye films have the largest share.

Eye drops are the simplest form of drug administration for the diagnosis, prevention and treatment of many eye diseases. Eye drops are liquid dosage forms, which are aqueous or oily solutions, thin suspensions or emulsions of medicinal substances, dosed in drops.

Due to the great sensitivity of the mucous membrane of the eye to many drugs (anaphylactic reaction), before prescribing certain drugs to patients, appropriate tests are carried out.

When prescribing eye drops to patients over 60 years of age, it is necessary to take into account that some medications can cause increased blood pressure and arrhythmia.