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Ocular Therapeutics Ashok Garg

SECTION 1: FUNDAMENTALS AND PRELIMINARY CONSIDERATIONS IN OCULAR THERAPEUTICS
1:Ocular Defense System
- PHYSICAL PROTECTION
- PHYSIOLOGICAL PROTECTION
2:Tear Film Physiology
- INTRODUCTION
- TEAR FILM FORMATION DYNAMICS
- NORMAL TEAR DRAINAGE
- TEAR COMPOSITION
- PHYSICAL PROPERTIES OF TEARS
- CHEMICAL COMPOSITION OF TEAR FLUID
- APPLIED PHYSIOLOGY
- HYPOSECRETION OF TEARS
  - Diagnostic Tests for Tear Hyposecretions (Table 2.10)
- HYPERSECRETION OF TEARS
  - Physiological Diagnostic Test for Hypersecretions
  - Special Tests
3:Aqueous Humor Dynamics
- INTRODUCTION
- BLOOD-AQUEOUS BARRIER
  - Breakdown of Blood-Aqueous Barrier
- AQUEOUS HUMOR FORMATION
- AQUEOUS HUMOR FORMATION REGULATION (CONTROL)
- RATE OF FLOW OF MOVEMENTS OF AQUEOUS HUMOR
  - Thermal Circulation
  - Bulk Flow
- ROUTES OF AQUEOUS OUTFLOW (ESCAPE)
  - Trabecular Meshwork Outflow (Conventional Outflow)
    - Vacuolation Theory
    - Uveoscleral Outflow Pathways
- AQUEOUS HUMOR COMPOSITION
  - Physical Properties
    - Osmolarity
    - Exchange of Substances between Aqueous Humor and Surrounding Tissues
  - Chemical Composition of Aqueous Humor
- FUNCTIONS OF AQUEOUS HUMOR
4:Routes of Administration and Drug Delivery Systems in Ophthalmology
- LOCAL APPLICATION
- SYSTEMIC ADMINISTRATION
5:Microorganisms and Ocular Diseases
- INTRODUCTION
- BACTERIA
- FUNGI
- VIRUSES
  - DNA Viruses
  - RNA Viruses
- PARASITES
- COMMON MICROBIOLOGICAL STAINS USED IN OPHTHALMOLOGY
- COMMON OPHTHALMIC CULTURE MEDIA AND USAGE (TABLE 5.1)
- NORMAL MICROBIAL FLORA OF THE EYE
  - Resident Flora
  - Transient Flora
6:Unique Ocular Drug Delivery Systems
- INTRODUCTION
- UNIQUE OCULAR DRUG DELIVERY SYSTEMS
- OTHER OCULAR DRUG DELIVERY SYSTEMS
- CONCLUSION AND NEW PERSPECTIVES
7:Antibacterial Therapy
- INTRODUCTION
- ROUTES OF ANTIMICROBIAL ADMINISTRATION IN OPHTHALMIC PRACTICE
- SELECTION OF ANTIMICROBIAL AGENTS
- INDICATIONS FOR ANTIMICROBIAL THERAPY
- MECHANISMS OF RESISTANCE TO ANTIBIOTICS
- STEPS TO BE TAKEN TO AVOID ANTIMICROBIAL RESISTANCE
- ANTIMICROBIAL COMBINATION THERAPY
  - Indications of Combination Therapy
  - Disadvantages of Antimicrobial Combination
- MICROBES CAUSING OCULAR INFECTIONS
- CLASSIFICATION OF ANTIBACTERIAL DRUGS (ACCORDING TO MECHANISM OF ACTION)
- DRUGS THAT INHIBIT BACTERIAL CELL WALL SYNTHESIS
- BETA-LACTAM ANTIBIOTICS
  - Mechanism of Action
  - Mode of Resistance
  - Penicillins
  - Penicillin G (Benzyl Penicillin/Crystalline Penicillin)
  - Penicillin V (Phenoxymethyl Penicillin)
  - Penicillinase Resistant Penicillins (Methicillin, Cloxacillin, Oxacillin, Dicloxacillin, Nafcillin)
  - Aminopenicillins (Ampicillin, Amoxycillin)
  - Carboxypenicillins (Carbenicillin, Ticarcillin)
  - Ureidopenicillins (Piperacillin, Mezlocillin, Azlocillin)
    - Adverse Effects of Penicillins
    - β-Lactamase Inhibitors
  - Cephalosporins
  - First Generation Cephalosporins
  - Second Generation Cephalosporins
  - Third Generation Cephalosporins
  - Fourth Generation Cephalosporins
  - Fifth Generation Cephalosporins
  - Carbapenems
    - Adverse Effects of Carbapenems
- GLYCOPEPTIDE ANTIBIOTICS
  - Mechanism of Action
  - Mode of Resistance
    - Antimicrobial Spectrum
    - Adverse Effects
- FOSFOMYCIN
- BACITRACIN
- DRUGS ATTACKING BACTERIAL CELL MEMBRANE
  - Daptomycin
  - Polymixin-B, Colistin and Tyrothricin
    - Dosage of Polymixin-B
- DRUGS THAT INHIBIT BACTERIAL PROTEIN SYNTHESIS
  - Aminoglycosides
- INDIVIDUAL DRUGS
  - Gentamicin
    - Dosage
    - Ocular Uses
  - Tobramycin
    - Dosage
    - Uses
  - Amikacin
    - Dosage
    - Ocular Uses
  - Neomycin
    - Dosage
  - Sisomycin
    - Dosage
  - Netilmicin
    - Dosage
  - Kanamycin
    - Dosage
  - Framycetin
  - Streptomycin
- SPECTINOMYCIN
- TETRACYCLINES
  - Classification
  - Mechanism of Action
  - Antimicrobial Spectrum
  - Mode of Resistance
  - Adverse Effects
  - Dosage
  - Systemic Uses of Tetracyclines
  - Ocular Uses of Tetracyclines
- GLYCYLCYCLINE—TIGECYCLINE
- CHLORAMPHENICOL
  - Antimicrobial Spectrum
  - Mechanism of Action
  - Mode of Resistance
  - Dosage
  - Ocular Uses
  - Adverse Effects
- MACROLIDES
  - Mechanism of Action
  - Mode of Resistance
- INDIVIDUAL DRUGS
  - Erythromycin
    - Dosage
    - Adverse Effects
  - Roxithromycin
  - Clarithromycin
    - Adverse Effects
  - Azithromycin
    - Dosage
    - Adverse Effect
  - Spiramycin
  - Uses of Macrolides
- KETOLIDES—TELITHROMYCIN
  - Dosage
  - Adverse Effects
- OXAZOLIDINONES—LINEZOLID
  - Antimicrobial Spectrum
  - Mechanism of Action
  - Dosage
  - Adverse Effects
  - Uses
- LINCOSAMIDES—CLINDAMYCIN
  - Dosage
  - Adverse Effect
  - Uses
- STREPTOGRAMINS— QUINUPRISTIN/ DALFOPRISTIN
- RETAPAMULIN
- FUSIDIC ACID
- DRUGS ATTACKING BACTERIAL DNA
  - Fluoroquinolones
- NITROIMIDAZOLES
  - Mechanism of Action
- DRUGS AFFECTING BACTERIAL INTERMEDIATE METABOLISM
  - Sulfonamides
- COTRIMOXAZOLE (TRIMETHOPRIM-SULFAMETHOXAZOLE)
  - Dosage of Cotrimoxazole
    - Adverse Effects of Sulfonamides and Cotrimoxazole
    - Clinical Uses of Sulfonamides and Cotrimoxazole
- MISCELLANEOUS AGENTS
- MUPIROCIN
- ANTIMICROBIAL PEPTIDES
  - Defensins
  - Cecropins
  - Magainins
- USE OF ANTIBIOTICS IN IRRIGATING SOLUTIONS FOR INTRAOCULAR SURGERY
- REASONS FOR FAILURE IN OCULAR ANTIBIOTIC TREATMENT
- CONCLUSION
8:Anti-inflammatory Therapy
- CORTICOSTEROIDS
- NONSTEROIDAL ANTI-INFLAMMATORY DRUGS
- VARIOUS TOPICAL NSAIDS USED COMMONLY IN OPHTHALMIC PRACTICE WORLDWIDE
- PHENYLALKANOIC ACIDS
- INDOLES
  - Indomethacin
- PHENYLACETIC ACID
- IMMUNOSUPPRESSIVE AGENTS IN OPHTHALMOLOGY
9:Antiviral Therapy
- INTRODUCTION
- DNA VIRUSES
- RNA VIRUSES
- MECHANISM OF VIRAL INFECTION/MULTIPLICATION
- GENERAL MECHANISMS OF ACTION OF ANTIVIRAL AGENTS
- CLASSIFICATION OF ANTIVIRAL DRUGS
- ANTIHERPES AGENTS
- DRUGS ACTIVE AGAINST CYTOMEGALOVIRUS
- DRUGS ACTIVE AGAINST HEPATITIS VIRUS
- DRUGS USED IN HIV INFECTION
- ENTRY INHIBITOR (MARAVIROC)
- FUSION INHIBITOR (ENFUVIRTIDE)
- INTEGRASE INHIBITOR (RALTEGRAVIR)
- CLINICAL USE OF ANTIRETROVIRAL THERAPY IN OPHTHALMOLOGY
- DRUGS ACTIVE AGAINST INFLUENZA VIRUS
  - Amantadine and Rimantadine
  - Oseltamivir and Zanamivir
10:Antifungal Therapy
- INTRODUCTION
- FUNGI CAUSING OCULAR INFECTIONS
  - Yeast Fungi
  - Filamentous Fungi
- ANTIFUNGAL DRUGS
  - Classification
- POLYENES
- ANTIMETABOLITE (FLUORINATED PYRIMIDINE)
  - Flucytosine
- AZOLE DERIVATIVES
- ALLYLAMINES
- ECHINOCANDINS
- SILVER COMPOUNDS
  - Silver Sulfadiazine
    - Dosage
    - Adverse Effects
11:Antiglaucoma Therapy
- VARIOUS FORMS OF OCULAR DRUG ADMINISTRATION
- AQUEOUS SOLUTIONS
- SUSPENSIONS
- OINTMENTS
- GELS
- OCULAR INSERTS
- DRUG COMPLIANCE
- PROSTAGLANDINS (HYPOTENSIVE LIPIDS; HLS)
- CARBONIC ANHYDRASE INHIBITORS
- α2-ADRENERGIC AGONISTS
- CHOLINERGIC DRUGS
12:Antiallergy Therapy
- INTRODUCTION
- TYPE 1 HYPERSENSITIVITY REACTIONS
- ANTIALLERGY MEDICATION
- TOPICAL MAST CELL INHIBITORS
- ANTIHISTAMINES
- ORAL ANTIHISTAMINES
- NSAIDs (ANTIPROSTAGLANDIN THERAPY)
- TOPICAL STEROIDS
- TOPICAL IMMUNOSUPPRESSORS
  - Cyclosporine
- RECENT ADVANCES IN IMMUNOSUPPRESSIVE THERAPY
  - Liposomes
13:Local Anesthetic Agents
- INTRODUCTION
- LOCAL ANESTHETICS (INJECTABLES)
- ESTERS
- AMIDES
- LOCAL ANESTHETICS (TOPICAL)
- SYNOPSIS OF OPHTHALMIC USES OF LOCAL ANESTHETICS
  - Local Injectable Anesthetics
  - Topical Anesthetics
14:Ophthalmic Viscosurgical Devices and Other Ocular Surgical Adjuncts
- INTRODUCTION
- VISCOELASTIC SUBSTANCES
- CRITERIA FOR SELECTION OF VISCOELASTIC MATERIAL
- ROLES OF VISCOELASTIC SUBSTANCES
- INDICATIONS FOR VISCOELASTIC SUBSTANCES
- COMMERCIALLY AVAILABLE VISCOELASTIC SUBSTANCES
- FUTURE VISCOELASTICS
- IRRIGATING SOLUTIONS
  - Intraocular Irrigating Solutions
    - Salient Features of BSS Plus Solution
  - Extraocular Irrigating Solutions
- SURGICAL ENZYMES
- SURGICAL ADJUNCTS
  - Fractionated Purified Silicone Oil
    - Visual Outcome and Clinical Results
  - Botulinum Toxin Type A
- CHELATING AGENTS, COLLAGENASE INHIBITORS and MUCOLYTICS
- CAUSTIC PREPARATIONS IN OPHTHALMOLOGY
- CYANOACRYLATE TISSUE ADHESIVES IN OPHTHALMOLOGY
15:Mydriatics and Cycloplegics
- INTRODUCTION
- MYDRIATIC ADRENERGIC AGENTS (SYMPATHOMIMETIC AGENTS)
- CHOLINERGIC ANTAGONIST AS MYDRIATIC AGENTS
- CYCLOPLEGIC MYDRIATICS
- MYDRIATIC COMBINATIONS
16:Ophthalmic Dyes
- INTRODUCTION
- FLUORESCEIN SODIUM
- FLUOREXON
- ROSE BENGAL
- LISSAMINE GREEN
- INDOCYANINE GREEN
  - Indications
  - Precautions
- TRYPAN BLUE
- VERTEPORFIN (VISUDYNE)
  - Verteporfin
17:Ocular Lubricants and Artificial Tear Solutions
- INTRODUCTION
- ARTIFICIAL TEAR SOLUTIONS
  - Methylcellulose or Ethylcellulose Base
    - Solutions Containing
- POLYVINYL ALCOHOL BASE SOLUTIONS
- LONGER LASTING MUCOADHESIVE OR INCREASED VISCOSITY AGENTS
- POLYVINYL PYRROLIDONE POLYMER BASE TEAR SOLUTION
  - Adverse Reactions of Artificial Tear Solutions
- OINTMENTS
  - Preparations
- OCULAR INSERTS (SOLID DEVICES)
- SOFT CONTACT LENS THERAPY
- PUNCTAL PLUGS
- COLLAGEN IMPLANTS
- MISCELLANEOUS PREPARATIONS
- RECENT ADVANCES IN NEW POLYMERS FOR DRY EYE SYNDROME
  - Stimulation of Tears
    - New Artificial Tear Preparations
  - New Polymers
18:Topical Immune Therapy
- INTRODUCTION
- OCULAR DEFENSE SYSTEM AND IMMUNITY
- INDICATIONS FOR TOPICAL IMMUNE THERAPY
  - Mechanism of Action
- DOSAGE
- CONTRAINDICATION
- ADVERSE REACTIONS
- SUMMARY
19:Topical Hyperosmotic Agents
- INTRODUCTION
- MAJOR CAUSES OF CORNEAL EDEMA
  - Mechanism of Action
- VARIOUS TOPICAL HYPEROSMOTIC AGENTS USED IN OPHTHALMOLOGY
  - Glycerine Solution
20:Antiretroviral Drug Therapy of Ocular Infections in AIDS
- INTRODUCTION
- HIV-RELATED RETINOPATHY
- OPPORTUNISTIC INFECTIONS OF THE EYE
  - Cytomegalovirus Retinitis
  - Cryptococcal Infection
  - Toxoplasma Infection
  - Pneumocystis carinii Choroiditis
- NONOPPORTUNISTIC INFECTIONS
  - Herpes Zoster Ophthalmicus
  - Herpes Simplex
  - Viral Disease of Eyelids
  - Syphilitic Uveitis
  - Choroidal Tuberculosis
- TUMOR INVOLVEMENT
  - Kaposi's Sarcoma
  - Lymphoma of Orbit
  - Squamous Cell Carcinoma of Conjunctiva
- NEURO-OPHTHALMOLOGICAL MANIFESTATIONS
- CUTANEOUS HYPERSENSITIVITY REACTIONS
- HIV IN OCULAR STRUCTURES
- OCULAR MANIFESTATIONS OF HIV INFECTIONS IN CHILDREN
- ANTIRETROVIRAL THERAPY OF OCULAR INFECTIONS IN AIDS PATIENTS
  - Nucleoside Reverse Transcriptase Inhibitors (NRTIs)
  - Non-nucleoside Reverse Transcriptase Inhibitors (NNRTIs)
  - Protease Inhibitors
  - Antiviral Metabolites
- CYTOMEGALOVIRUS INFECTION
  - Ganciclovir
  - Intravenous Dosage
  - Oral Ganciclovir
  - Intravitreal Injection of Ganciclovir
  - Ganciclovir Implant (Intravitreal Devices)
  - Foscarnet
  - Treatment Efficacy
- BREAKTHROUGH RETINITIS
  - Newer Modalities
    - Cidofovir/Zidofovir (HPMPC)
    - Protease Inhibitors in CMVR
- TOXOPLASMA INFECTION
  - Complications
- HERPES ZOSTER OPHTHALMICUS
- MYCOBACTERIUM TUBERCULOSIS
  - Dosage
- MYCOBACTERIUM AVIUM INTRACELLULARE
- OCULAR SYPHILIS
- ACUTE RETINAL NECROSIS
- PNEUMOCYSTIS CARINII CHOROIDITIS
  - Fungal Infections
- RECENT ADVANCES IN ANTIRETROVIRAL DRUG THERAPY
  - Fomivirsen Sodium (Vitravene)
21:Sterilization, Disinfection and Antiseptics in Ophthalmology
- PHYSICAL METHODS
- CHEMICAL METHODS
  - Ethylene Oxide (C2H4O)
  - Formalin
    - Precautions When using Formalin
- SOAKING IN LIQUID CHEMICALS
- AIDS AND DISINFECTION IN RELATION TO OPHTHALMOLOGY
22:Miscellaneous Drugs in Ophthalmology
- INTRODUCTION
- LID SCRUBS
  - Indications
  - Dosage and Administration
- ASTRINGENT OPHTHALMIC SOLUTION
  - Indications
  - Administration and Dosage
- OPHTHALMIC DIAGNOSTIC TEAR TEST STRIPS
  - Indications
  - Precautions
- HAMAMELI'S OPHTHALMIC SOLUTION
- BORIC ACID
- INACTIVE INGREDIENTS IN OPHTHALMIC PRODUCTS
- VISCOSURGICAL DEVICES
23:Ocular Drug Toxicity: Complications
- INTRODUCTION
  - Generalized Ocular Manifestations of Drug Toxicity
- COMPLICATIONS OF TOPICAL ANTIMICROBIAL AGENTS
- COMPLICATIONS OF STEROIDS
- SYSTEMIC ADVERSE REACTIONS OF GLAUCOMA MEDICATIONS
- COMPLICATIONS OF TOPICAL OCULAR ANESTHETIC AGENTS
- TOXICITY OF SURGICAL SOLUTIONS
- COMPLICATIONS OF CONTACT LENS SOLUTIONS
- COMPLICATIONS OF INTRAVENOUS FLUORESCEIN
- CLASSIFICATION OF ADVERSE REACTIONS
- DRUG-INDUCED OCULAR CICATRIZATION
  - Clinical Manifestations
- SYSTEMIC DRUGS CAUSING OCULAR TOXICITY
24:Topical and Systemic Ophthalmic Drugs with Common Dosages
- ANTIBIOTIC THERAPY
  - Topical Antibiotic Solutions and Ointments
    - Usual Dosage
  - Systemic Antibiotics in Ophthalmology
    - Dosage
- TOPICAL ANTI-INFLAMMATORY THERAPY
  - Corticosteroids
  - Corticosteroid Antibiotic Combinations
  - Topical Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
  - Immunosuppressive Agents in Ophthalmology
- ANTIVIRAL THERAPY
- ANTIFUNGAL THERAPY
- ANTIGLAUCOMA THERAPY
  - Miotics
  - Alpha-adrenergic Agonists
  - Sympathomimetics
  - Adrenergic Blocking Agents (Beta-blockers)
  - Carbonic Anhydrase Inhibitors
  - Prostaglandins
  - Ocular Hypotensive Lipids
  - Hyperosmotic Agents
  - Antimetabolites/Antifibroproliferative Agents
  - Neuroprotective and Neuroregenerative Agents
    - Alpha-2 Agonists
- ANTIALLERGY THERAPY
  - Topical Mast Cell Inhibitors
  - Antihistamines
    - Usual Dose
  - Decongestants
  - Topical NSAIDs
  - Topical Steroids
  - Topical Immunosuppressors
- LOCAL ANESTHETIC AGENTS
  - Injectable Agents
    - Esters
    - Amides
  - Topical Anesthetic Agents
- MYDRIATICS AND CYCLOPLEGICS
  - Mydriatic Adrenergic Agents
  - Cholinergic Antagonist as Cycloplegic Mydriatics
  - Mydriatic Combinations
- ARTIFICIAL TEARS AND LUBRICANTS
  - Methylcellulose or Ethylcellulose Base
  - Polyvinyl Alcohol-base Solutions
  - Longer Lasting Mucoadhesive or Increased Viscosity Agents
  - Polyvinylpyrrolidone Polymer-base Tear Solution
  - Ointments
  - Ocular Inserts (Solid Devices)
  - Punctal Plugs
  - Miscellaneous Preparations
- OPHTHALMIC VISCOSURGICAL DEVICES
- IRRIGATING SOLUTIONS
  - Intraocular Irrigating Solutions
    - BSS Containing
    - BSS Plus (Mix aseptically before use)
  - Extraocular Irrigating Solutions
- SURGICAL ENZYMES
  - Chelating Agents and Mucolytics
  - Caustic Preparations
  - Cyanoacrylate Tissue Adhesive
- SURGICAL ADJUNCTS
  - Fractionated Purified Silicone Oil
  - Polydimethyl Siloxane (Silicone Oil)
  - Povidone Iodine
  - Absorbable Gelatin Film
  - Botulinum Toxin Type A
- TOPICAL IMMUNE THERAPY
- TOPICAL HYPEROSMOTIC AGENT
  - Hypertonic Salt Agent
  - Glycerine Solution
- ANTICATARACT THERAPY
  - Topical Agents
  - Systemic Therapy
- MEDICAL THERAPY FOR ARMD (AGE-RELATED MACULAR DEGENERATION)
  - Antioxidants
  - Antiangiogenic Agents
  - Growth Factors
- MEDICAL THERAPY FOR DIABETIC RETINOPATHY
- OPHTHALMIC DYES
  - Fluorescein Sodium
  - Fluorexon
  - Rose Bengal
- CONTACT LENS CARE PRODUCTS
  - Rigid Gas Permeable (RGP) Contact Lens Products
  - Soft (Hydrogel) Contact Lens Products
- RECENT MULTIPURPOSE SOFT LENS CARE SYSTEMS
- ANTIRETROVIRAL DRUGS IN OPHTHALMIC INFECTIONS
  - Nucleoside Reverse Transcriptase Inhibitors
  - Non-nucleoside Reverse Transcriptase Inhibitors
  - Protease Inhibitors
  - Antiviral Metabolities
  - Recent Advances in Antiretroviral Drug Therapy
    - Fomivirsen Sodium (Vitravene)
- OCULAR THERAPEUTICS IN REFRACTIVE SURGERY
  - Photorefractive Keratectomy
    - Preoperative Ocular Therapeutics
    - Postprocedure Ocular Therapeutic Module
  - Lasik Surgery
    - Preprocedure Therapeutic Medications
    - Postprocedure Therapeutic Modulation
  - Recent Update in Post PRK/Lasik Surgery Therapeutic Module
25:Ocular Manifestations of Systemic Diseases
- INTRODUCTION
- VARIOUS SYSTEMIC DISEASES
26:Quick Look Tabulated Ocular Therapeutics Information
- ANTIBACTERIALS
- COMBINATION ANTIBIOTICS
- ANTI-INFLAMMATORY DRUGS
  - Topical Steroidal Agents
  - Nonsteroidal Anti-inflammatory Agents
- TOPICAL STEROID-ANTIBIOTIC COMBINATIONS
- ANTIVIRAL THERAPY
  - First Generation Drugs
- ANTIFUNGAL THERAPY
  - Polyenes
  - Imidazole Derivatives
  - Fluorinated Pyrimidines
  - Silver Sulphadiazine
  - Terbinafine
- ANTI-ALLERGY THERAPY
  - Mast Cell Inhibitors
  - Antihistamines
  - Decongestants
  - Decongestants and Antihistamines Combination
  - Topical NSAIDs and Topical Steroids—See Anti-inflammatory Tables
    - Topical Immunosuppressors
- ANTIGLAUCOMA THERAPY
  - Miotics
    - Cholinergic Agents
    - Anticholinesterase Agents
  - Alpha Adrenergic Agonists
  - Sympathomimetics
  - Beta Blockers
- CARBONIC ANHYDRASE INHIBITORS
  - Prostaglandins
  - Hyperosmotic Agents
  - Ocular Hypotensive Lipid (OHL)
  - Antimetabolites
- LOCAL ANESTHETIC AGENTS
  - Injectable Agents
    - Esters
    - Amides
  - Topical Anesthetic Agents
- LOCAL ANESTHETIC COMBINATIONS
- MYDRIATICS AND CYCLOPLEGICS
  - Mydriatic Adrenergic Agents
  - Cholinergic Antagonist as Cycloplegic Mydriatics
  - Mydriatic Combinations
- OPHTHALMIC VISCOSURGICAL DEVICES (OVD) AND SURGICAL ADJUNCTS
  - Viscoelastic Substances
  - Irrigating Solutions
    - Intraocular Irrigating Solutions
    - Extraocular Irrigating Solutions (EIS)
  - Surgical Enzymes
  - Chelating Agents and Mycolytics
  - Caustic Preparations
  - Cyanoacrylate Tissue Adhesive
  - Surgical Adjuncts
- OPHTHALMIC DYES
- LUBRICANTS and ARTIFICIAL TEAR SOLUTIONS
  - Methylcellulose and Ethylcellulose Base
  - Polyvinyl Alcohol-base Solutions
  - Miscellaneous Artificial Tear Solutions
- TOPICAL IMMUNE THERAPY
- TOPICAL HYPEROSMOTIC AGENTS
- CONTACT LENS CARE PRODUCTS
  - Hard Lenses
  - Rigid Gas Permeable (RGP) Lenses
  - Soft Lenses (Hydrogel)
  - Surfactant Cleaning Solutions (Soft Lenses)
  - Enzymatic Cleaners (Soft Lenses)
    - Disinfecting/Wetting/Soaking Solution (Soft Lenses)
- REWETTING SOLUTIONS (SOFT LENSES)
- NONSURGICAL ADJUNCTS
  - Lid Scrubs
  - Tear Test Strips
  - Hamameli's Water
- BORIC ACID
  - Astringent Ophthalmic Solution
  - Vitamin and Antioxidants
  - Topical Anticataract Therapy
  - Medical Therapy for Diabetic Retinopathy
  - Disinfective and Antiseptic agents in ophthalmology
SECTION 2: APPLIED OCULAR THERAPEUTICS IN OPHTHALMIC SURGERY
27:Comprehensive Review of Topical Ophthalmic Antibacterial Agents: Their Mechanisms of Action and Adverse Effects Including Long-Standing Drugs and the Most Recent Preparations
- BACTERIAL CONJUNCTIVITIS
- BACTERIAL KERATITIS
- PROPERTIES OF TOPICAL OPHTHALMIC ANTIBACTERIAL AGENTS
  - Fluoroquinolones
  - Adverse Effects
- EXTEMPORANEOUSLY COMPOUNDED FORTIFIED ANTIBIOTICS
- AMINOGLYCOSIDES
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- BACITRACIN
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- BETA-LACTAM ANTIBIOTICS
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- CHLORAMPHENICOL
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- MACROLIDES
- ERYTHROMYCIN
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- AZITHROMYCIN
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- POLYMYXIN AND COMBINATION PRODUCTS
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- SULFACETAMIDE
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- TETRACYCLINES
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- VANCOMYCIN
  - Chemistry, Ophthalmic Preparation, and Pharmacologic Action
  - Clinical Experience and Ophthalmic Uses
  - Adverse Effects
- SELECTING THE OPTIMAL OPHTHALMIC ANTIBIOTIC
  - Goals of Treatment
- CLINICAL JUDGMENT IN CHOOSING AN OPHTHALMIC ANTIBIOTIC
- BACTERIAL CONJUNCTIVITIS
  - Common Prescribing Practices
- BACTERIAL KERATITIS
  - Common Prescribing Practices
- NORFLOXACIN 0.3 percent SOLUTION
28:Preoperative and Postoperative Antibiotic Prophylaxis in Cataract Surgery
- ANTIBIOTIC PROPHYLAXIS
  - Topical Antibiotics
    - Gentamicin
  - Trimethoprim-Polymyxin B Sulphate
- CHLORAMPHENICOL
- TOPICAL FLUOROQUINOLONES
- LOMEFLOXACIN
  - Ofloxacin
- FOURTH GENERATION FLUOROQUINOLONES
  - Subconjunctival Antibiotics
- INTRACAMERAL ANTIBIOTICS
29:Management of Iatrogenic Inflammation of the Eye
- TOPICAL APPLICATION
- USE OF NONSTEROIDAL ANTI-INFLAMMATORY DRUGS IN INFLAMMATION
- CONCLUSION
30:Management of Postrefractive Keratitis
31:Ocular Pharmacotherapeutics in Corneal Refractive Surgery
- PREPROCEDURE THERAPEUTIC MEDICATIONS
  - Topical Anesthesia
- POSTPROCEDURE THERAPEUTIC MEDICATIONS
  - Phases of Healing
32:Antioxidants and Their Role in Ophthalmology
- CLASSIFICATION OF ANTIOXIDANTS
- CONCLUSION
- SUMMARY
33:Tetracyclins for Ocular Surface Diseases
34:Clinical Applications of Antimycotic Agents in the Eye
- INTRODUCTION
- KERATOMYCOSIS
  - Treatment of Fungal Keratitis
- ORBITAL CELLULITIS
  - Treatment Modalities for Orbital Cellulitis
- DACRYOCYSTITIS
  - Treatment of Dacryocystitis
- ENDOPHTHALMITIS
  - Intravitreal Amphotericin B
    - Systemic
  - Influence of Fungal Species on Therapeutic Outcome of Infection
35:Recommended Antibiotic Dosages for Various Clinical Conditions of the Eye
36:Endophthalmitis Prevention Strategies
- NEW CONCEPTS IN ENDOPHTHALMITIS TREATMENT
- EXISTING LITERATURE
- PRACTICAL CLINICAL PRACTICE
- MICROBIAL ANTIBIOTIC RESISTANCE
37:Management of Myopic Choroidal Neovascularization
- PHOTODYNAMIC THERAPY
- INTRAVITREAL ANTI-VEGF DRUG INJECTION
- SUMMARY
38:Treatment of Central Serous Choroidopathy
- INTRODUCTION
- DIFFERENTIAL DIAGNOSIS
- TREATMENT
- PATHOGENESIS
- CASE REPORT (FIGURES 38.1 TO 38.9)
39:Treatment of Retinal Angiomatous Proliferation
- NATURAL HISTORY
- CONCLUSION
40:Conjunctival Allergen Challenge for Evaluating Anti-inflammatory Therapy
- INTRODUCTION
- METHODS
- RESULTS
- SUMMARY
  - Repeat Measurements After Instillation of Vasoconstrictor/Antihistamine Eyedrops
- DISCUSSION
41:Steroid Therapy for Allergic Ocular Disease
- NEW CONCEPTS IN TOPICAL STEROID THERAPY
  - The True Risk to Benefit Profile for Allergic and Ocular Surface Disease
  - Insufficient Steroid Treatment Adversely Impacts Outcomes
- THE NATURE OF ALLERGIC DISEASE
  - Molecular Biology Allows Better Understanding of Ocular Allergic Diseases
  - Reversible Inflammation
- COMBINED SURFACE DISEASES PRESENT DIAGNOSTIC CHALLENGES
- INNOVATIVE STRATEGIES FOR OCULAR SURFACE DISEASES
- BLEPHARITIS EXACERBATES DRY EYES AND ALLERGY
- STEROIDS FOR CONTACT LENS WEARERS AND REFRACTIVE SURGERY PATIENTS
  - Awareness of Ocular Surface Disease
  - Challenging Refractive Patients and Informed Consent
42:Optimizing Visual Outcomes with NSAIDs Therapy in Cataract and Refractive Surgeries
- RATIONALE FOR TREATING OCULAR INFLAMMATION
- PHARMACOLOGIC THERAPY FOR OCULAR INFLAMMATION
43:Immunosuppressive Drugs in Ophthalmology
- INTRODUCTION
- SELECTION OF PATIENTS
- ALKYLATING AGENTS
- ANTIMETABOLITES
  - Clinical Indications
  - Dosage
    - Azathioprine
    - Methotrexate Dosage
- ANTIBIOTIC CYCLOSPORIN A
- OCULAR DRUG TOXICITY OF IMMUNOSUPPRESSIVE AGENTS USED IN OPHTHALMIC CONDITIONS
- RECENT ADVANCES IN IMMUNOSUPPRESSIVE THERAPY
  - Liposomes
44:Management of Cystoid Macular Edema
- INTRODUCTION
- DEFINITION
- ETIOLOGY
- HISTOPATHOLOGY
- CLINICAL FINDINGS
- PARACLINICAL APPROACH
- TREATMENT
  - Nonsurgical Approach
  - Surgical Approach and Drugs Related
- CONCLUSION
45:Blepharitis
- CLASSIFICATION
- GENETICS
- INFECTION
- ALLERGY
- CORNEAL MANIFESTATIONS
- CHEMISTRY
- TREATMENT
- SUMMARY
46:Trypan Blue in the Management of Mature Cataract
- INTRODUCTION
- RHEXIS IN MATURE CATARACTS
- TRYPAN BLUE
- TECHNIQUE
- ADVERSE EFFECTS
- STERILIZATION
- INDOCYANINE GREEN DYE
- SUMMARY
47:Trypan Blue Assisted Epiretinal Membrane Removal
- INTRODUCTION
- PATIENTS AND TECHNIQUE
- RESULTS
- CONCLUSION
48:Perfluorocarbon Liquids in Vitreoretinal Surgery
- INTRODUCTION
- TYPES
- PHYSICAL PROPERTIES
- INDICATIONS
- MISCELLANEOUS
- OTHER MEDICAL APPLICATIONS
- COMPLICATIONS
49:Use of Tissue Adhesives in Ophthalmology
- CYANOACRYLATE TISSUE ADHESIVES
  - Uses in Ophthalmology
  - Mechanism of Bonding
- HUMAN FIBRIN GLUES
- RECENT ADVANCES IN TISSUE ADHESIVES IN OPHTHALMOLOGY
50:Photodynamic Therapy (Verteporfin) in Age-related Macular Degeneration
- INTRODUCTION
- TECHNIQUE
  - Verteporfin
  - Post-treatment Regime
- PREPARATION OF THE PATIENT FOR PDT
- CALCULATION OF THE TREATMENT SPOT SIZE REQUIRED COVERING THE CNV
- CONCLUSION
51:Indocyanine Green Angiography
- INTRODUCTION
- ADVANTAGES OF ICG
- HISTORY
- PHARMACOLOGY
- TOXICITY
- TECHNIQUE
- VARIOUS PHASES OF ICG ANGIOGRAPHY
- ICG IN AGE RELATED MACULAR DEGENERATION
- SUMMARY
52:Management of Dry Eye—Current Trends and Recent Advances
- MEDICAL MANAGEMENT
- ONGOING CLINICAL TRIALS
53:Management of Endophthalmitis: Antibiotic Schedule and Dosages
- ACUTE POSTOPERATIVE ENDOPHTHALMITIS
- CONCLUSION
54:Surgical Techniques of Glued IOL
- INTRODUCTION
- SCLERAL FIXATED IOL
- FIBRIN GLUE
- SURGICAL TECHNIQUE
- DISCUSSION
- SUMMARY
55:Intraocular Gases
- PHYSICAL PROPERTIES OF GASES
- INTRAOCULAR GAS GEOMETRY
  - Surface Tension, Buoyancy and Arc of Contact
- INTRAOCULAR GAS KINETICS
- EFFECT OF ANESTHETIC GASES AND ATMOSPHERIC DEPRESSURIZATION
- CLINICAL CONSIDERATIONS
- CHOICE OF GAS
- NONEXPANSILE CONCENTRATION
- TECHNIQUES OF FLUID-AIR EXCHANGE AND INTRAOCULAR GAS INJECTION
  - For Pneumatic Retinopexy
    - Preparation of the Gas
    - Injection of Gas
- CLINICAL USES
- POSTOPERATIVE MANAGEMENT
  - Postoperative Visits and Postoperative Care
  - Postoperative Intraocular Pressure Management
- TOXICITY AND COMPLICATIONS
56:Pharmacology of Anti-VEGF Therapy
- VASCULAR ENDOTHELIAL GROWTH FACTOR AND ANGIOGENESIS
  - Pharmacology of Anti-VEGF Agents
- ADMINISTRATION OF ANTI-VEGF THERAPY
- SIDE EFFECTS OF ANTI-VEGF THERAPY
- CONCLUSION
SECTION 3: RECENT ADVANCES IN OCULAR THERAPEUTICS
57:Toxic Anterior Segment Syndrome
- INTRODUCTION
- CONCLUSION
58:Anesthesia Trends in Ophthalmology
- HISTORY
- PERIOPERATIVE WORKUP
- TRENDS IN TOPICAL ANESTHESIA
- TRENDS IN REGIONAL ANESTHESIA
- AUTHOR'S TECHNIQUE
- SUMMARY
- NOTE
59:Azithromycin in Ophthalmology: A New Therapy
- TOPICAL AZITHROMYCIN EYEDROP (AZASITE)
  - Chemical Characteristics
- CHEMICAL STRUCTURES OF AZITHROMYCIN AND ERYTHROMYCIN
  - Pharmacokinetics
  - DuraSite Drug Delivery System
- MODELED BIOAVAILABILITY OF AZITHROMYCIN FROM AZASITE
  - Clinical Trials
  - Expanded Killing Profile
- CONCLUSION
60:Use of Beta-adrenergic Blockers in Ocular Vascular Diseases
- INTRODUCTION
61:Clinical Applications of Anti-inflammatory and Anti-protease Effects of Tetracyclines in Ocular Surface Disease
- SUMMARY
62:Optimized NSAIDs and Antibacterial Regimen is Key to Ocular Surgical Prophylaxis
- POSTOPERATIVE SCHEDULE FOR CATARACT PATIENTS
  - Drug Dosages
- MEASURING POTENCY
- PENETRATION TRACKING
- SAFETY EVALUATION
63:Ophthalmic Medications in Pediatric Age Group
- INTRODUCTION
- PRECAUTIONS
- MYDRIATIC AGENTS
  - Adrenergic Agonist
    - Phenylephrine Hydrochloride
  - Cycloplegic Agents/Parasympatholytics
- GLAUCOMA MEDICATIONS
- ANTI-INFLAMMATORY DRUGS
  - Steroids
  - Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
- ANTI-ALLERGY MEDICATIONS
- ANTIBIOTICs
  - Beta-lactams
    - Mechanism of Action
    - Preparations
  - Dosage and Routes of Administration
    - Side Effects and Safety
- SULfONAMIDES
- AMINOGLYCOSIDES
- MACROLIDES
- TETRACYCLINES
- CHLORaMPHENICOL
- FLUoROQUINOLONES
- ANTIVIRALS (Table 63.5)
- ANTIFUNGALS
- CONCLUSION
64:Management of Uveitis in Children
- JUVENILE IDIOPATHIC ARTHRITIS ASSOCIATED UVEITIS
  - Diagnosis
  - Management
- FUCHS HETEROCHROMIC UVEITIS
  - Management
- INTERMEDIATE UVEITIS
  - Diagnosis
  - Management
- BEHÇET'S DISEASE
  - Management
- TOXOPLASMOSIS
  - Clinical Features
  - Management
- TOXOCARIASIS
- SUMMARY
65:Management of Anticoagulation Therapy in Elective Ophthalmic Procedures
- IDENTIFYING THE PATIENTS AT RISK
- RISK OF BLEEDING COMPLICATIONS
- MODIFYING ANTITHROMBOTIC THERAPY DURING OPHTHALMIC SURGERY
- INTRAOPERATIVE CONSIDERATIONS TO REDUCE BLEEDING IN PATIENTS USING ANTICOAGULATION THERAPY
66:Ocular Pharmacology of Intravitreal Dexamethasone Sustained Release Implant
- INTRODUCTION
- MECHANISM OF ACTION
- CHEMICAL FORMULA
- TECHNIQUE
- PHARMACOKINETICS
  - Pharmacokinetics in Vitrectomized and Non-vitrectomized Eye
- INDICATIONS
- CONTRAINDICATIONS
- ADVERSE EFFECTS
67:Nanotechnology in Ophthalmology
- INTRODUCTION
- MEDICINE AND NANOTECHNOLOGY
- NANOTECHNOLOGY IN OPHTHALMOLOGY
- OCULAR DISTRIBUTION OF NANOPARTICLES
- FUTURE OF NANOTECHNOLOGY
68:Photochemical Therapy for Corneal Infections
- INTRODUCTION
- ANTIMICROBIAL EFFECTS OF PCTCI
- MICROBIAL KERATITIS FOLLOWING CXL
  - Bacterial Keratitis
- MICROBIAL KERATITIS FOLLOWING OTHER PDT APPROACHES
- ANTIMICROBIAL EFFECT OF OTHER PDT APPROACHES
- CONCLUSION
69:Recent and Future Drugs in Ophthalmology
- INTRODUCTION
- RECENT AND EMERGING DRUGS
- NEW DRUG DELIVERY IN OPHTHALMOLOGY
- BIOLOGICAL TRANSPORTERS AND PRODRUGS
- COLLOIDAL CARRIERS AND NANOPARTICLES
- CONCLUSION

INDEX

TOC
Index

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Chapter Notes