The Wills Eye Manual by Bagheri Nika & Wajda Brynn & Calvo Charles & Durrani Alia

Author:Bagheri, Nika & Wajda, Brynn & Calvo, Charles & Durrani, Alia
Language: eng
Format: epub
ISBN: 978-1-4963-5366-5
Publisher: LWW
Published: 2016-04-18T16:00:00+00:00

Treatment

Tends to be very responsive to topical steroids and aqueous suppressants.

1. Topical β-blocker (e.g., timolol 0.5% daily or b.i.d.), topical α-2 agonist (e.g., brimonidine 0.1% to 0.2% b.i.d. to t.i.d.), topical CAI (e.g., dorzolamide 2% b.i.d. to t.i.d.).

2. Short course (1 week) of topical steroids (e.g., prednisolone acetate 1% q.i.d.) may decrease inflammation. Longer use may cause an elevation in IOP. Oral indomethacin (e.g., 75 to 150 mg p.o. daily) or topical nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g., ketorolac q.i.d.) may also be effective.

3. Consider a systemic CAI (e.g., acetazolamide 500 mg sequel p.o. b.i.d.) if IOP is significantly increased and unresponsive to topical therapy (rare).

4. Hyperosmotic agents (e.g., mannitol 20% 1 to 2 g/kg i.v. over 45 minutes) or anterior chamber paracentesis can be considered when the IOP is determined to be dangerously high for the involved optic nerve (SEE APPENDIX 13, ANTERIOR CHAMBER PARACENTESIS).

5. Consider a cycloplegic agent (e.g., cyclopentolate 1% t.i.d.) if the patient is symptomatic.

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