eye drop

Definition of eye drops

Aqueous or oily medicines for use on the eye are called eye drops (Oculoguttae) designated. The drops are dripped into the conjunctival sac and so the active ingredient contained in the drug can act locally.

Areas of application of eye drops

Typically, eye drops are used to treat the following conditions:

• Irritation or
• Dryness of the eye
  Read more on the topic: Eye drops for dry eyes
  
• in glaucoma,
• for a corneal (Keratitis) or
• Conjunctivitis (Conjunctivitis)

Eye drops for conjunctivitis

• Eye drops for conjunctivitis
• Eye pain

Types of eye drops

1. Non-prescription moisturizing eye drops

(= "Artificial tears) (e.g. Hyaluronic acid)

Obtain the non-prescription eye drops short-term relief For dry eyes, at them not a serious illness present.

Dry eyes can result

• lack of sleep
• long work on the computer
• Television viewingn or
• stay in rooms with low humidity

arise.

Eye drops that mixed with preservatives are, prevent although one Spread of bacteria and can be used for a while after opening, but it can too allergic reactions and Hypersensitivity come across these preservatives. Most of the preservative free However, eye drops are only available in doses Single use available to prevent bacterial growth.

2. Non-prescription eye drops for redness

(e.g. Euphrasia officinalis, Tetryzoline)

The second most common type of over-the-counter eye drops are the ones at Swelling or redness can be used. This redness can be due to irritation

• insufficient moistening of the surface of the eye and thereby increased friction of the eyelid
• Allergies
• a generally dry climate
• fatigue

occur.

Decongestant eye drops reduce the redness caused by the Contraction of blood vessels of the eye. Therefore, these drops can only help to a certain extent, and one often occurs Getting used to the active ingredientsso that the eye can follow no longer responds as well to some applications.
If used excessively, the eye drops can also lead to one Dilated pupil to lead.

3. Antiallergic eye drops

(e.g. levocabastine, Antazoline, Tetryzoline)

An allergy is usually the cause of eye problems if the dryness and redness are accompanied by itching and / or swelling.

As difficult as it is not to rub the itchy eyes, it must be avoided, as otherwise the eye tissue will be additionally irritated.
Antiallergic eye drops are often referred to as antihistamines, which means that they reduce the itchy histamine (the body's own messenger substance in allergic reactions) in the eye tissue.

4. Prescription anti-inflammatory eye drops

(e.g. Dexamethasone, fluorometholone)

There are two different types of eye drops used for inflammation:

• Corticosteroids (steroid hormones)
• Non-steroids (e.g. diclofenac, indomethacin, nepafenac).

Corticosteroids are used to reduce inflammation of the iris (Iritis) or conjunctiva (Conjunctiva) and / or to treat corneal inflammation. These eye drops require a prescription because they have powerful side effects.

5. Prescription antibiotics and antiviral eye drops

Viral or bacterial conjunctivitis can be treated with special eye drops.
Symptoms of bacterial conjunctivitis include

• red, inflamed eyes
• sticky, yellowish secretion encrusted in sleep

The symptoms of viral conjunctivitis are

• red, moist looking eyes
• clear to white secretion

Bacterial conjunctivitis is often treated with antibiotic drops (e.g. Ofloxacin, chloramphenicol) treated.

Mild forms of viral conjunctivitis can also be prevented by regular wetting with eye drops (e.g. Acyclovir )be treated. However, great care must be taken to avoid contact between the bottle and the eye, as otherwise the virus infection will spread.

Antibiotic preparations are also used for stubborn barley grains on the eye or eyelid margin. In order to be able to work longer, they are usually available in the form of ointments.

Read on below: Eye ointment for a stye

6. Prescription glaucoma eye drops

(e.g. ocular beta blockers and Prostaglandin analogs)

Eye drops specifically made for the treatment of glaucoma (glaucoma) have the property of reducing the tear fluid production of the eye or of inducing drainage of the eye and thus pressure equalization.
Because of the severe and irreversible damage that untreated or improperly treated glaucoma can cause, medical glaucoma surveillance is absolutely essential.

Common side effects that may occur from the use of glaucoma eye drops include:

• Visual disturbances
• a headache
• Cardiac arrhythmias
• Difficulty breathing
• sexual dysfunction

More types of eye drops

Local anesthetic eye drops for local anesthesia:

• Cocaine (Magistral recipe)
• Oxybuprocaine eye drops
• Proxymethacaine

Mydriatics to dilate the pupil:

• Parasympatholytics: Atropine, scopolamine
• Sympathomimetics: Cocaine, ephedrine, phenylephrine

Disinfectant for local disinfection:

• Hexamidine

Diagnostics for use on the eye:

• Fluorescein

Eye drops for red eye

Reddened eyes can have many different causes. In order to treat them, it is first necessary to determine why the eyes are red. Depending on the cause, appropriate eye drops can then be used or another treatment initiated. The doctor decides this.

The eyes may be red when they are very dry, i.e. when there is insufficient tear fluid covering the eyeball. (see also: dry eyes) In this case are Tear substitutes as an eye drop is a suitable option.
Red eyes can also occur due to an allergic reaction. Here the use of antiallergic eye drops is advisable and leads to symptom relief.

With an existing Conjunctivitis the eyes are also reddened. Conjunctivitis can have different causes. Either she is like on external stimuli Drafts, smoke, dust or foreign body and can be treated with artificial tears or Euphrasia eye drops, or it is due to bacterial or viral pathogens.
Viral conjunctivitis does not usually require any special treatment. It can be symptomatic, i.e. with artificial tears or Euphrasia Eye drops are treated.
In the case of bacterial conjunctivitis, an antibiotic is often necessary. This can be used in the form of antibiotic eye drops and will provide symptom relief and prevent the bacteria from spreading further.

In addition, you can Cornea- or Eyelid skin- Inflammations lead to reddened eyes. Inflammation of the dermis or the iris can also cause this. In any case, a doctor should be consulted before eye drops of any kind are used on reddened skin, as it can be a serious illness.

Eye drops for dry eyes

Dry eyes occur due to insufficient tear fluid in the eye. Then the tear film over the eyeball is not sufficient to supply the eye with fluid and a Burning in the eyes and a constant Foreign body sensation in the eye. This can be caused by insufficient tear production by the lacrimal gland.

Tear substitutes can be used as eye drops for dry eyes. They cause more fluid in the eye and the tear fluid to be replenished. Tear substitutes mainly contain water, but also synthetic substances such as Polyacrylate, Povidone or Polyvinyl alcohol. Also Hyaluronic acid as a fluid reservoir can be included.

Tear substitutes are available from the pharmacy. When buying, you should make sure that it does not contain any preservatives. The permanent effect of preservatives on the eye can damage the tear fluid as well as the mucous membranes and the cornea. Since tear substitutes for dry eyes are used regularly in most cases, there is a high risk of damage here.

Even when wearing contact lenses caution is advised. Some products are incompatible with contact lenses, which should be considered when choosing a suitable tear substitute.

Eye drops for allergies

In the case of allergies to pollen or animal hair, the eyes are often also affected. These are then reddened, swollen, and burning or itchy. You can effectively counter this with eye drops.

If the allergy is not very pronounced, you can try to relieve the symptoms, i.e. itchy or burning eyes, with Euphrasia eye drops or artificial tears. But this is often not enough. Antiallergic eye drops are available from pharmacies. It should be ensured that eye drops without preservatives are used, as these protect the mucous membranes even with long-term use.

An allergic reaction is caused by the release of histamine in the body due to an overreaction to certain external stimuli (e.g. Pollen, animal hair) triggered. Histamine then leads to the typical symptoms. There are antiallergic eye drops with different active ingredients. They are based on the inhibition of the release of histamine.
Many preparations contain cromoglizic acid. These eye drops are more likely to be taken preventively if no allergic symptoms have occurred. There are also eye drops with the active ingredients Azelastine or tetryzoline. These work much faster and thus also alleviate acute symptoms. It should be noted, however, that these preparations may only be used for about 5 to 7 days at a time, as otherwise the conjunctiva can be damaged. Also Cetirizine and Loratadine are suitable as antiallergic eye drops.
They are helpful for any type of allergy and are very effective. However, it can lead to fatigue here.

In the case of long-term and severe allergies, a desensitization should be considered by the doctor in order to permanently alleviate the symptoms.

Learn more about the topic: Eye drops for an allergy

Eye drops for conjunctivitis

In conjunctivitis, the affected eye is swollen, reddened and often tender. Conjunctivitis can develop due to various causes. It can be caused by an allergy, for example with hay fever. Depending on the symptoms that occur, moisturizing eye drops can improve the symptoms. Here, for example, so-called artificial tears or Euphrasia, also known as "Eyebright", be applied. If these do not provide adequate relief, alternative treatments, such as desensitization, should be discussed with the doctor.

Conjunctivitis can also be caused by external stimuli such as drafts, smoke, dust or foreign bodies. Here too, moisturizing eye drops can alleviate the symptoms.

If conjunctivitis is caused by a bacterial or viral infection, your doctor may prescribe eye drops containing other active ingredients. Both types of conjunctivitis caused by the pathogen are contagious and should therefore be treated.
If bacteria are the trigger, eye drops containing antibiotics or eye ointments are used. Depending on which bacteria are involved, different antibiotics can be used.

Read more on the topic: Floxal

​​​​​​​
Viral conjunctivitis usually heals on its own and usually only requires symptom-relieving eye drops such as euphrasia or artificial tears. If the conjunctivitis is caused by herpes viruses, acyclovir can help.

When choosing eye drops, a doctor should always be asked for advice, who can identify the cause of the conjunctivitis and initiate appropriate therapy.

Read more on the topic: Eye drops for conjunctivitis

Eye drops for contact lenses

Wearing contact lenses disrupts the tear film of the eye and reduces the tear fluid. This can quickly lead to dry eyes and the associated burning or itching.

Eye drops can then help keep the eyes moist. However, there are a few things to keep in mind.

The eye drops used should absolutely be free of preservatives when using soft contact lenses, as otherwise the contact lenses could absorb the preservatives and attack the cornea.

Eye drops with hyaluronic acid are also very suitable, as hyaluronic acid is an endogenous substance and releases moisture to the eye. Eye drops without preservatives and possibly with hyaluronic acid can then also be applied directly to the eye wearing contact lenses.

An eye ointment can also be applied at night to help moisturize the eye. If you already know that your eyes tend to be dry, you should consider a few things when choosing contact lenses.

Good advice from the ophthalmologist or optician and the individual adjustment of the lenses is important here. The lenses should have the smallest possible diameter and consist of a material that is as permeable as possible. There are now even special lenses for dry eyes that are made from a gel or silicone or contain a hyaluronic acid reservoir.

Do you suffer from dry eyes from contact lenses? - Then read our article Dry eyes from contact lenses

Eye drops for hay fever

Since hay fever is an allergy, antiallergic eye drops help very well. As already mentioned in the section “Eye drops for allergies”, blocking the release of histamine is particularly important.

This can be achieved with eye drops with cromoglizic acid. These eye drops should be used about 2 weeks before the onset of the allergy, as they are then the most effective way of blocking the release of histamine. So you have a preventive effect.

Another possibility are eye drops with the classic so-called “antihistamines” such as levocabazine or azelastine. These active ingredients block the docking points of histamine and thus its allergic effect.

When applied directly to the eye, they have a local effect and only pass into the blood in very small quantities.They also act very quickly and can therefore be used in an acute episode. However, they should not be used for more than 5 to 7 days in a row.

Would you like to know what else you can do about your hay fever? - Then read our article Therapy of hay fever

Eye drops for cataracts

According to the current state of knowledge, cataracts can only be treated with an operation. Eye drops alone cannot cure or prevent cataracts.

However, some preparations are currently being used whose effectiveness has not been proven. These include vitamins, amino acids, minerals, antioxidants and herbal medicines.

However, some eye drops are used in conjunction with surgery to relieve complications and pain.

One day before the operation and up to 14 days afterwards, so-called NSAID eye drops are used to treat any inflammation or pain that may occur. Eye drops containing antibiotics are used before and after the operation to prevent possible infections.

Would you like to know more about cataract treatment? - Then read our articles on that Cataract treatment or the Cataract surgery

Eye drops with cyclosporine

Ciclosporin is one of the so-called calcineurin inhibitors. They have anti-inflammatory and immunosuppressive effects and are therefore used for some inflammations.

In the form of eye drops, it is used for severe inflammation of the cornea (keratitis). However, only after other drugs, such as B. tear substitutes, so moisturizing eye drops, did not help.

In addition, cyclosporine eye drops are only used for corneal inflammation caused by dry eyes.

Ciclosporin A eye drops are also approved for the treatment of vernal keratoconjunctivitis. Vernal keratoconjunctivitis is a bilateral, recurring inflammation of the eye that occurs intermittently.

This leads to severe inflammation of the surface of the eye, the conjunctiva and the cornea, which can lead to loss of vision.

Ciclosporin A eye drops can also be used for so-called keratoconjunctivitis sicca. Keratoconjunctivitis sicca is also known as "dry eye syndrome" and is characterized by a reduced wetting of the cornea and conjunctiva with tear fluid. There is also inflammation of the cornea and conjunctiva.

Find out more here Ciclospoprine A

Eye drops with antibiotic

If you suspect a long-term disease of the eye due to a bacterial infection, eye drops that contain an antibiotic are helpful.

An example of a bacterial infection of the eye is conjunctivitis. However, in adulthood, a viral cause is more often the cause of conjunctivitis.

A doctor should clarify in advance whether it is actually a viral conjunctivitis.

In childhood, however, conjunctivitis is more often viral than bacterial.

Regarding treatment with antibacterial eye drops, however, it should be said that the application of the eye drops should initially be carried out cautiously. Current recommendations on how to deal with bacterial conjunctivitis describe waiting three days from the onset of symptoms before using antibacterial eye drops.

In the meantime, tear substitutes, i.e. eye drops for dry eyes, are sufficient for treatment, because in most cases the inflammation heals without the use of antibiotics.

However, if symptoms persist after three days, an ophthalmologist should be consulted, who can then prescribe antibacterial eye drops. Various antibiotics are used for this, which are used several times a day or hourly depending on the severity. These include aminoglycosides such as tobramycin, gentamycin or azithromycin. For more severe courses, fluoroquinolones such as ciprofloxacin and ofloxacin can also be used.

Would you like to find out more about this topic? - Then read our main article about Eye drops containing antibiotics

Eye drops with cortisone

Cortisone eye drops are also known as “prednisolone eye drops”. Prednisolone is a synthetically produced active ingredient and is very similar to cortisone.

Therefore, prednisolone eye drops are colloquially referred to as cortisone eye drops. Cortisone has anti-inflammatory, anti-allergic and immunosuppressive effects and is used in ophthalmology for non-infectious eye infections.

This also includes inflammation of the eyelids, cornea or conjunctiva. Non-infectious causes of such inflammation can be allergic conjunctivitis (allergic rhinoconjunctivitis or chronic allergic conjunctivitis), autoimmune diseases such as ocular pemphigoid or the so-called dry eye syndrome (keratoconjunctivitis sicca), which is caused by impaired wetting of the cornea and conjunctiva is conditioned to be.

Treatment with cortisone, however, is not the first choice for the diseases mentioned and also has many side effects. The treatment may cause pressure inside the eye to increase or cataracts may develop. Therefore, you should definitely remain under an ophthalmologist's care during the treatment.

Would you like to find out more about eye drops containing cortisone? - Then read our article Eye drops containing glucoids

Eye drops with adrenaline

Eye drops with adrenaline are used by the ophthalmologist for examinations of the fundus (ophthalmoscopy).

The adrenaline causes the pupils to dilate and the blood vessels to constrict in the eye. The ophthalmologist can see and assess the eye and the fundus better with a special magnifying glass.

The examination is carried out if you have visual impairment or sudden vision loss, flickering eyes, seeing lightning bolts, injuries to the eye or previous illnesses such as diabetes mellitus or high blood pressure.

Damage or changes to the optic nerve, the retina, the blood vessels of the retina, the point of sharpest vision (macula lutea) or tumors of the eye can be detected at an early stage and subsequently treated.

After the examination, you are not allowed to drive a car for a few hours, as the dilation of the pupils can impair vision. The effects last for about five hours. The drops should not be used during pregnancy or breastfeeding.

Would you like to read more about an ocular fundus examination? - Then read our article Ophthalmoscopy - ophthalmoscopy

Eye drops with hyaluronic acid

Eye drops with hyaluronic acid are often so-called tear substitutes, i.e. eye drops for the treatment of dry eyes.

Hyaluronic acid is a natural reservoir of fluid that, for example, binds the fluid in our connective tissue and ensures the necessary elasticity of the skin.

This function is then also used as a component in the eye drops. Tear substitutes are available from pharmacies without a prescription from a doctor.

Tear substitutes are mainly used for dry eyes, but also for eye irritation, eye inflammation or conjunctivitis. They are also used by many contact lens wearers to improve the comfort of the lenses.

You may also be interested in the following article: Inflammation of the eye - how dangerous is it?

Eye drops with vitamin A.

Eye drops in the form of tear substitutes can contain vitamin A as an additive. The vitamin A is also known colloquially as the eye vitamin, as it plays a central role in the visual process.

It also improves the tear film, which is why it also helps with dry eyes. Therefore, it can be found in some tear substitutes. The eye drops with vitamin A, like all other tear substitutes, can be bought at the pharmacy without a prescription from a doctor.

Euphrasia eye drops

Euphrasia is a medicinal plant, the medicinal effect of which is not considered certain in Germany. Therefore, Euphrasia is not approved as a herbal medicine and is only used as a homeopathic remedy.

Euphrasia is said to have antibacterial, analgesic and anti-inflammatory effects, especially on the eyes, and is therefore also known as “eyebright”.

Therefore, Euphrasia finds a particularly common application in the form of eye drops. Euphrasia eye drops can then e.g. B. in conjunctivitis that is not purulent, or swelling of the eyelid (eyelid edema).

There is also eyebright tea, in which z. B. compresses or eye bands can be soaked to treat the eye. Euphrasia globules or eye ointments are also available. As already mentioned, an effect has not been proven with certainty.

Would you like to find out more about Euphrasia eye drops? - Then read our article Euphrasia eye drops - how do they work?

Manufacture and distribution

Eye drops are recommended according to the European Pharmacopoeia (Ph. Eur.) sterile and may only be sold in pharmacies as pharmacy-only drugs in Germany.

The eye drops are available either in disposable plastic ampoules or in small bottles made of special glass (amber glass). In addition to industrial production, the eye drops are also mixed directly in the pharmacy according to the prescription of the prescribing ophthalmologist.

Eye drops should have a physiological pH of 7.4 (Isohydria) and have an osmotic pressure that corresponds to that of the corneal epithelium (Isotonicity) so that the eye is not unnecessarily irritated.

However, most active ingredients are not chemically stable enough under these pH conditions. For this reason, the pH value of the eye drops is adjusted with alkalis or acids so that an optimal stability of the active ingredient is achieved, but the pH value is still at a physiologically tolerable level (euhydric) Range (approx. PH 7.3 to 9.7).

After instillation in the eye, the pH value is adjusted to the physiological pH value by the buffer effect of the tear fluid.
Since the buffer capacity of the protein / phosphate and bicarbonate buffers in the tear fluid is only very small, eye drops must not themselves have a buffer capacity.
Isohydric eye drops can be equipped with a buffer.