ORAL MEDICATIONS WITH OCULAR SIDE EFFECTS ASHLEY S

ORAL MEDICATIONS WITH OCULAR SIDE EFFECTS ASHLEY S. REDDELL, OD, FCOVD HOACLS 2015

ABOUT ME • FROM HAYSVILLE, KS • GRADUATED FROM KU…. . ROCK CHALK! • WORKED AS A VISION THERAPIST DURING UNDERGRAD • GRADUATED FROM SOUTHERN COLLEGE OF OPTOMETRY • COMPLETED PEDIATRIC RESIDENCY AT SCO • JOINED A PRIVATE PRACTICE IN LEAVENWORTH IN 2010 • NOW HAVE 3 LOCATIONS, 5 ODS, AND ~28 STAFF

HOUSEKEEPING • I HAVE NO FINANCIAL INTERESTS IN ANY OF THE PRODUCTS I MAY MENTION DURING THIS PRESENTATION. • IF YOU HAVE QUESTIONS PLEASE EMAIL ME…. AREDDELL@FAMILYEYECARECENTERLV. COM

WHY GIVE THIS COURSE TO PARA-OPTOMETRICS? • YOU HAVE ONE OF THE MOST IMPORTANT JOBS IN THE OFFICE…. GETTING PATIENT HISTORY • MEDICATIONS ARE A VERY IMPORTANT PART OF THAT HISTORY • MANY COMMON MEDICATIONS HAVE OCULAR SIDE EFFECTS, IT IS IMPORTANT FOR YOU TO MAKE SURE THE DOC IS AWARE IF PATIENT IS TAKING ANY THAT WE DISCUSS

CORNEA • AMIODARONE • ANTIARRHYTHMIC • VORTEX KERATOPATHY

CORNEA • GOLD SALTS • RHEUMATOID ARTHRITIS • OCULAR CHRYSIASIS

CORNEA • HYDROXYCHLOROQUINE • PLAQUENIL • TX: MALARIA, RHEUMATOID ARTHRITIS, SYSTEMIC LUPUS ERYTHEMATOSUS • VERTICILLE KERATOPATHY

CORNEAL SYMPTOMS • GLARE • PHOTOPHOBIA • HALOS AROUND LIGHTS • NIGHT DRIVING COMPLAINTS

CONJUNCTIVA • ANTI-COAGULANTS • ASPIRIN • COUMADIN • PLAVIX • VITAMIN E

CONJUNCTIVAL SYMPTOMS • RED EYE • TYPICALLY PAINLESS • MAY BE ASSOCIATED WITH STRAINING, COUGHING, SNEEZING, ETC.

PUPIL MYDRIASIS – DILATED PUPIL • EPINEPHRINE • BRONCHODILATOR • PRIMATENE MIST • EPHEDRINE • BRONCHODILATOR • PRIMATENE TABLET

PUPIL MYDRIASIS – DILATED PUPIL • PSEUDOEPHEDRINE • SUDAFED • COLD/HAY FEVER DECONGESTANTS • SCOPOLAMINE • PATCH USED FOR MOTION SICKNESS

PUPIL MIOSIS – CONSTRICTED PUPIL • MORPHINE • INSECTICIDES

PUPIL • TAMSULOSIN • FLOMAX • IMPROVES URINATION IN MEN WITH BENIGN PROSTRATE HYPERPLASIA • CAUSES INTRAOPERATIVE FLOPPY IRIS SYNDROME • IMPERATIVE TO KNOW BEFORE CATARACT SURGERY

PUPIL SYMPTOMS • MUST BE AWARE OF NARROW ANGLES AND POTENTIAL FOR MYDRIASIS • DILATED PUPIL(S) • LIGHT SENSITIVITY

LENS • CORTICOSTEROIDS • PREDNISONE • USED TO TREAT INFLAMMATION

LENS • PHENOTHIAZINES • CHLORPROMAZINE • ANTIPSYCHOTICS • ANTERIOR STELLATE CATARACT

LENS SYMPTOMS • GLARE/HALOS • REDUCED VISUAL ACUITY • GREATER WITH PSC • COMMUNICATE WITH PROVIDERS • WEIGH PROS AND CONS OF MEDICATION VS. SIDE EFFECTS

DRY EYE • ANTI-HISTAMINES • EXP: CLARITIN • ANTI-CHOLINERGICS • EXP: BENADRYL, SCOPOLAMINE • ANTI-ANXIETY MEDS • EXP: XANAX • SELECTIVE SEROTONIN REUPTAKE INHIBITOR • EXP: ZOLOFT, CELEXA, PROZAC

DRY EYE • DIURETICS • USED TO TREAT HYPERTENSION • HORMONE REPLACEMENT THERAPY • ESTROGEN

RETINA • PLAQUENIL • HYDROXYCHLOROQUINE • TX: MALARIA, RA, SLE • RETINOPATHY

RETINA • TALC • ADDITIVES TO IV DRUGS • IMPORTANT TO ASK SOCIAL HISTORY

RETINA • TAMOXIFEN • TX FOR BREAST CANCER

RETINA SYMPTOMS • REDUCED VISION • DIMMING OF VISION • GLARE • DISTORTION IN CENTRAL VISION

OPTIC NERVE • CORTICOSTEROIDS • TX INFLAMMATION: RA, COLITIS, ASTHMA, BRONCHITIS • LONG TERM USE CAN CAUSE INCREASED IOP

OPTIC NERVE/RETINA • SILDENAFIL • VIAGRA • VISUAL SIDE EFFECTS • BLUISH-TINGED, PINK-TINGED, YELLOWISH-TINGED VISION • CAN LAST SEVERAL MINUTES TO HOURS • THOUGHT TO AFFECT PHOTOTRANSDUCTION

OPTIC NERVE • TETRACYCLINES • ANTIBIOTICS • SOMETIMES USED TO TX ACNE IN TEENS • CAN CAUSE OPTIC NERVE HEAD EDEMA • ORAL CONTRACEPTIVES

OPTIC NERVE SYMPTOMS • CHANGES IN COLOR VISION • REDUCED VISION • VISUAL FIELD CHANGES

QUESTIONS • AREDDELL@FAMILYEYECARECENTERLV. COM