Botulinum Toxin

Botulinum toxin (Botox ) has gained widespread use primarily for cosmetic and oculoplas-tic procedures as well as limited use in the treatment of strabismus. Derived from a bacterial toxin, its action arises from blocking the release of acetylcholine. When injected directly into the targeted muscle, it causes a paralysis or relaxation of that muscle. Thus, it is used to relax an over-active extraocular muscle (to straighten the eye) or to calm spasms of the eyelid. The drug's maximal effect is...

The Allergic Reaction

An allergic reaction is simply the overresponse of the immune system to a specific stimulus, usually environmental. This stimulus is called an antigen. There are 4 basic types of allergic reactions. We are all very familiar with the type 1 response. This reaction is seen as a result of hay fever, bee stings, cats, dogs, or even medications. It is the cause of the itchy, watery eyes, and runny nose many of us experience each spring when we cut the grass or stroll through the park. A brief look...

Antiviral Therapy

Viruses are the smallest of all the infectious agents. They work by invading and taking charge of a cell's genetic and reproductive machinery. They use their newly acquired machinery to reproduce new viruses, which then repeat the process again. Thankfully, this highly effective invasion is stopped by our own immune system, and most viral infections are acute and self-limiting. Occasionally, however, a virus can invade and set up camp in a dormant or latent state. The latent state protects the...

Artificial Tears

The number of artificial tear preparations available over the counter is overwhelming (Tables 5-1 and 5-2). This is evidenced by a single glance at the shelf in the local pharmacy. Artificial tears contain various components and different combinations of buffers, tonicity agents, polymers, and occasionally preservatives and vitamins. The major therapeutic component in artificial tears is the water-soluble polymer. These agents determine the viscosity (thickness) of the artificial tear solution...

Supplement Toxicity

Patients and practitioners alike must understand that the benefits of these agents have been demonstrated but are in no way a substitute for a balanced diet. In addition, excessive amounts of antioxidants can lead to adverse effects. For example, excessive vitamin E can lead to muscle Table B-1 Nutritional Supplements for the Eyes Bilberry 2020 Bright Eyes CataRx Eyebright Eye Formula EyePower Eye Support Isight and I-Care Itone Lipotriad Lutein Compiled by Roy H. Rengstorff, OD, PhD. Used with...

Acyclovir

The use of oral acyclovir (Zovirax ) has proven effective in the treatment of both ocular and nonocular manifestation of herpes simplex virus and varicella zoster virus. The usual regimen for herpes simplex virus is 400 mg 5 times daily. Unlike most oral anti-infectives, acyclovir is able to reach therapeutic levels in the tears and aqueous. Though shown effective when used alone, it is usually paired with topical trifluridine for better action. For varicella zoster infections, the dosage is...