All medicines can have side effects and can sometimes cause problems as well as cure
disease. Fortunately, eye drops can be used to treat most eye diseases. Because only
a little of the medication enters the rest of the body, side effects are lessened.
Nevertheless, it must not be forgotten that many eye drops are potent medicines which
have the potential to affect your general health as well as your eye.
If troublesome symptoms occur when using an eye drop, you should discuss the
problem with your physician or the assistant. If your physician decides your symptoms
are caused by your drops, another drop or some other way of treating the problem may
be suggested. Sometimes, eye drops are so important that some side effects may
simply have to be tolerated.
Different brands of drops may contain the same medicine or a combination of several
different medicines. Medicines named in this pamphlet will be referred to by their
“generic” name, which can be found in the fine print on the label. The package insert
provides more detailed information about uses, warnings and side effects. You should
call your ophthalmologist if you have questions.
ALLERGY
Be sure to let your physician know if you are allergic to any medicines. Any medicine
can cause allergy, even non-prescription drops which have chemical preservatives.
Allergic reactions to eye drops often lead to itching, swelling and a rash around the
eyes. Sometimes patients interpret this as a worsening of the condition for which they
started using drops and so use the drops more frequently. If your eyes or eyelids
become more red, itchy or swollen after you begin using a drop, you should tell your
ophthalmologist.
DROPS IN THE DORCTOR’S OFFICE
Dilating Drops. During your eye examination your doctor may need to “dilate” or
enlarge the pupils of your eyes to obtain a better view of the inside of your eyes.
Children’s eyes are often dilated to help measure for glasses. Dilating drops frequently
blur vision for a varying length of time, and bright light may be bothersome so that some
patients have difficulty driving immediately after the examination. It is not possible for
your ophthalmologist to predict how much your vision will be affected. Therefore, it is
best if you make special transportation plans or bring another driver with you to the
examination.
Anesthetic Drops. These drops numb the eyes within a few seconds of application.
They seem miraculous to patients with a scratch on their eye but unfortunately they can
be harmful to the surface of the eye with repeated use and can cause serious scarring.
They should be used only in the doctor’s office to make examination possible and
should not be used at home.
Non-Prescription Drugs. Many drops are available at the drug store without a
prescription. Artificial tear drops are simple lubricating solutions which may be very
helpful in soothing irritated eyes. They may be used as frequently as needed.
Decongestant drops contain a medicine (tetrahydrozoline, naphazoline, phenylephrine)
which whitens the eyes by constricting blood vessels. These are generally harmless if
not used too frequently. They do not improve the health of the eye, but may relieve
symptoms by making the eye appear less red. If you use these drops frequently, the
eye may actually become more red and irritated when the drops are stopped. And
remember, even non-prescription eye drops can cause an allergic response.
PRESCRIPTION EYE DROPS
Corticosteroid (Cortisone-Like Drops). These drops are extremely potent and should
be used only under your ophthalmologist’s direct guidance. Using them without your
ophthalmologist’s knowledge for a problem which seems similar to an earlier problem is
dangerous. Whenever these drops are used, the eye’s ability to fight infection and to
repair injury is reduced. Prolonged use can lead to decreased vision (from glaucoma or
cataracts). Sometimes these drops are so important that they must be used in spite of
the risk of these problems. Many different brands of drops containing corticosteroid are
available. Prednisolone, dexamethasone, hydrocortisone, fluoromethalone and
medrysone are frequently used corticosteroids.
Drops for Infection. All “red” or “pink” yes are not necessarily infected. If your
ophthalmologist feels you have an infection which may respond to a drug, it will be
prescribed for you. No single medicine is effective against all types of infections, and
some infections cannot be treated with any available drop. Improvement may take
several days. If your condition worsens while you are using the drop, you should notify
your ophthalmologist, since your infection may be resistant to the drop or you may be
developing an allergic reaction to the drop.
Glaucoma Drops. Glaucoma usually is caused by the fluid pressure inside the eyeball
becoming too high for the health of the eye. Some glaucoma drops decrease the
amount of fluid formation within the eye, and others increase the fluid drainage from the
eye. All of these drops have possible side effects. Sometimes the drops have possible
side effects. Sometimes the drops are necessary and side effects may have to be
tolerated.
Bottles identified by bright green tops contain eye drops which make the pupils smaller.
They may cause blurred vision in younger patients and inpatients with cataracts. When
first used, they may cause aches above the brow which usually go away after a few
days. A rare but serious side effect is retinal detachment which may be accompanied by
the sudden appearance of dark floating spots or flashing lights. Such symptoms should
be reported to your physician immediately.
Drops such as timolol are called “beta-blockers” and can cause breathing difficulty in
patients with asthma or emphysema and may cause slow or irregular heartbeat in some
patients. Your physician should be advised if you have breathing difficulty or heart
problems so you can be advised about starting the drop, you should stop the drop and
notify your physician.
Epinephrine can cause temporary redness of the eye and enlargement of the pupil. It
can also cause rapid or irregular heartbeat. Once again, if you feel ill after using any eye
drop, stop and tell your ophthalmologist.
INSERTING EYE DROPS
Putting drops in the eye can be difficult at first but becomes easier with practice. The
best way for most patients is to tilt the head back and pull the lower lid away from the
eye. This can be done by pulling down with one finger or by pinching the lower lid and
pulling outward with two fingers. This forms a pocket between the eye and lower lid into
which a drop may be inserted. Try to let the medicine fall from the bottle into this pocket
to prevent contamination of the bottle. Afterwards, close the lids and apply pressure for
a minute or two over the point where the lids meet the nose.
If you have additional questions or would like further information about eye drops,
contact your ophthalmologist.
