Therapeutics News

---Foreign bodies can consist of metal, glass, plastic, concrete, grass and dirt. This metallic foreign body resulted from hammering a nail. The foreign body should be removed and patients should be treated for pain and prevention of infection.

The ability to diagnose medical eye problems and prescribe therapeutic pharmaceutical agents (TPAs) is crucial to providing primary care to our patients. If optometry is to become the primary entry point for eye problems in managed care settings, practicing at this level is essential. It is also very rewarding both professionally and financially to the optometrist to care for the patient with eye disease. Managing patients before and after surgery, handling red eyes and caring for the long-term needs of the glaucoma patient establishes strong bonds between the doctor and patient.

AHOSKIE, N.C. - In this small, rural town of about 5,000, solo practitioner Brad Hauser, OD, could not get through the day without a very important practice-building tool - his prescription pad.

Cromolyn sodium has been commonly used to treat giant papillary conjunctivitis (GPC), a condition seen less frequently in clinical practice since the advent of disposable soft contact lenses. Today, cromolyn sodium is still used for problems experienced by a few patients wearing disposable lenses, but more typically it is used for conventional soft lenses wearers. These are challenging patients because they frequently wear toric lenses with high cylinder or are wearing high powers of either myopic or hyperopic correction.

With an increasing number of antihistamines available, it seems there is no allergy your patients cannot conquer once you have made the proper diagnosis. Many of the newer, second-generation antihistamines offer patients the benefits of allergy relief without the side effects of their first-generation predecessors, namely, drowsiness and dry mouth.

Homatropine is often used in our practice because it complements steroid and nonsteroidal anti-inflammatory drug (NSAID) therapy. In the case of bacterial keratitis, it gives us an option to help calm the anterior chamber reaction without resorting to steroids early in the course of treatment. Seldom is homatropine used by itself, but as additive treatment it plays an important role in primary care optometry.

BIRMINGHAM, Ala. - Have you hesitated to begin using therapeutics? This allergy season, why not try treating itchy eyes? It can be gratifying to treat seasonal allergic conjunctivitis (SAC) because it tends to be intermittent and self-limited. Jimmy Bartlett, OD, FAAO, says SAC is a good place to start, because "Many of the drugs are non-toxic and available over the counter. You don't have to worry too much about side effects," he said.

Leo P. Semes, OD: This discussion will focus on drugs that have been introduced during the past 24 months. Let's start with Trusopt (dorzolamide, Merck). The indicated dosing is three times a day for glaucoma. Has anybody gone away from that? Has anybody decided to stick with that? Do you prescribe it differently as an additive medication? Has anybody used it for a first-line medication?

Flarex (fluorometholone acetate 0.1%, Alcon) and eFLone (fluorometholone, Ciba Vision Ophthalmics) are useful when inflammation is mild to moderate and the risk of the inflammation escalating is minimal. Anterior uveitis from trauma, mild chemical inflammation and postoperative treatment of photorefractive keratectomy (PRK) are specific cases for which I would consider using this steroid.

CHICAGO - Newer drugs are definitely blunting the effects of allergic diseases. Livostin (levocabastine HCl, Ciba Vision) has rapidly become a standard for many practitioners. When Livostin fails or when cost is not a factor, Patanol (olopatadine, Alcon) is a big favorite.