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Drugs Which May Be Used by Certified Optometrists

Certified optometrists use a variety of drugs to treat ocular conditions. Pain is often associated with ocular conditions and many of the drugs prescribed are pain relievers from simple OTCs such as Aleve, Celebrex and Motrin to antibiotic eye drops and various analgesics, steroids, non-steroids and anesthetics. Optometrists however do try to use primary treatment before prescribing medications, particularly narcotics, largely due to the fact that all pain is based on a high level of subjectivity.

  1. Anesthetics

    • Examples of anesthetics used by certified optometrists include proparacaine, benoxinate, tetracaine and lidocaine. Proparacaine is the most popular. It reduces stinging, burning, damage to the cornea and allergic reactions. Benoxinate and fluoresceine sodium dye are combined in some procedures and the combination of anesetics is common in optometry. Lidocaine for example is combined with epiniephrine which constricts blood vessels in order to decrease bleeding and increase numbing qualities. Tetracaine is used in the same manner of proparacaine, but not as often, as it causes bacterial growth.

    Analgesics

    • Certified optometrists use analgesics to treat more serious ocular pain. Analgesics are derived from opiates and their effects resemble those of morphine. Central-acting and peripheral-acting are two types of analgesics other than anesthetics. Examples of analgesics include codeine, hydrocodone, oxycodone, propoxyphene and tramadol. Central-acting analgesics are more potent but addictive while peripheral-acting analgesics are not, but fail to affect stronger types of pain. The Drug Enforcement Agency identifies respiratory depression, sedation and gastrointestinal problems as negative side-effects of analgesics in addition to addiction, suggesting only short-term usage.

    Steroids and Non-Steroids

    • Non-Steroidal Anti-Inflammatory Drugs or NSAIDs relieve mild to moderate pain by by interrupting its transmitters. Molecular structure and chemical characteristics determine NSAID classes. Common brand-name NSAIDs include Advil, Motrin and Nuprin, as well as Aleve, Vioxx and Celebrex. Propionic acid is the most common NSAID prescribed for pain stronger than that treated by brand-name NSAIDs. Corticosteroids reduce inflammation and pain caused by ocular diseases such as uveitis, scelitis, optic neuitis and orbital pseudotumor. Prednisone, or the brand name Prelone, is a commonly available corticosteroid, preferred by most practitioners.

    Antibiotic Eye Drops

    • Antibiotic eye drops are one of the most commonly prescribed topical antibiotics by optometrists. Antibiotic eye drops have a high placebo affect and are also used as a catch-all when optometrists are confronted with a difficult diagnosis. Bacitracin treats bacterial corneal ulcers. Trimethoprim treats soft tissue infections. Erhythromycin acts as a nighttime lubricant. Azithromycin treats bacterial ocular infections and is available in eye drop form. Chloramphenicol treats bacterial conjunctivitis but is rarely used within the United States due to possible side effects and the availability of more effective alternative medications.

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