Anti-Inflammatory Drugs, Nonsteroidal

NSAIDs are used to relieve the eye pain, potential swelling, irritation and discoloring related to eye disorders and after eye surgery.

Overview

Ophthalmic NSAIDs are used to reduce the inflammation that can occur in the eye or the surrounding areas due to an infection or other health issues. Eye health includes conditions such as blindness, allergies, sties and muscular degeneration (AMD). It also treats a condition called edema, which causes fluid to build up in the eye, interfering with one’s sight.

Usually a surgical procedure for cataracts, cornea transplant or a vision complaint is necessary and may be connected to one of these ailments - astigmatism, blurry vision, hyperopia and myopia. NSAIDs is used to prevent inflammation before and after surgery, speeding up the healing process. In either case, the objective is to reduce the swelling that can make it difficult for a surgeon or doctor to reach some areas of the eye.

Ophthalmic is only available with a doctor’s prescription.

NSAIDs are available in both brand and generic names – they are known for causing bleeding which has instigated stricter FDA warnings. You need to be aware that NSAIDs increase the risk of several health disorders when taken in high doses.

Condition(s) Treated

  • Refractive errors
  • Cataracts
  • Optic nerve disorders
  • Glaucoma
  • Retinal disorders
  • Macular degeneration
  • Diabetic eye disorders
  • Conjunctivitis
  • Lens implants
  • Cysts
  • Dry eye syndrome
  • Pinguecula eye discomfort

Type of Medicine

  • Ophthalmic Route

Side Effects

Besides being pain reducers and inflammation suppressers, NSAIDs also affect metabolic processes when taken by certain individuals with existing health conditions or persons who are more sensitive to certain medicinal chemical compounds. It is important to talk with your doctor when you are not feeling well after taking your medications.

NSAIDs cause side effects in some patients while others report no problems at all. In either case, understanding your condition and the potential side effects associated with NSAIDs will help with the healing process. Some side effects are more common and less serious, while others can be life threatening depending on the individual's health.

If any of these conditions occur, you need to contact your doctor.

  • Bleeding in the eye
  • Redness or swelling of the eye
  • Blurred vision
  • Change in vision
  • Fever
  • Unusual itching
  • Abnormal tearing
  • Nausea or vomiting
  • Sight sensitivity
  • Pain
  • Discharge
  • Shortness of breath
  • Coughing or wheezing
  • Mild ocular stinging, irritation
  • Abdominal pain
  • Corneal deposits
  • Corneal edema
  • Conjunctivitis

Most common

  • Burning or stinging sensation
  • Discomfort
  • Dry eyes

Least common

  • Change in pupil size
  • Headaches
  • Trouble sleeping
  • Fatigue
  • Sinus problems

Side effects can appear shortly after treatment and disappear overtime as your body adjusts to the treatment with no need for further medical attention. It is always a good idea to talk with your doctor just in case an adjustment needs to be made to prevent more serious side effects from occurring.

There are many known side effects, but there may be others not listed. Since each person is different and responses are diverse, if you are uncomfortable or the side effect lingers, notify your doctor or pharmacist at once. These side effects may also reveal underlying illnesses that now need to be attended to.

Understand, your doctor has selected this medicine to treat your condition as the best method with fewer risks and increased benefits for healing faster.

Serious allergic reactions to NSAIDs have been known to occur. If you do experience an allergic reaction, seek medical assistance immediately.

  • Rash
  • Itching
  • Swelling of the face, throat or tongue
  • Dizziness
  • Trouble breathing

Other possible health disorders affected by treatment of NSAIDs:

  • Stomach pain
  • Heartburn
  • Stomach ulcers
  • Ringing in the ear
  • Liver or kidney problems
  • Blood pressure issues
  • Eyelid swelling
  • Corneal perforation
  • Corneal thinning

Dosage

Ophthalmic NSAIDs come in two forms for dispensing treatment. The first is called a suspension and the second is a solution. The differences between the two may be different drug components used to treat underlying conditions or causes. The contents could be comprised of antibiotics, antihistamines, corticosteroids or prostanoids.

Average content may vary depending on the brand:

  • Dosage 0.1% , 0.3% or 0.5%

NSAIDs, Ophthalmic

  • Acular
  • Acular LS
  • Acuvail
  • Bromfenac ophthalmic
  • BromSite
  • Diclofenac ophthalmic
  • Flurbiprofen ophthalmic
  • Llevro
  • Ketorolac ophthalmic
  • Ketorolac/phenylephrine ophthalmic
  • Nepafenac ophthalmic
  • Nevanac
  • Omidria
  • Prolensa
  • Voltaren ophthalmic

These are sterile treatments – contamination of the dropper’s surface or the medicine can lead to more serious eye infections. If an infection occurs or the eye becomes irritated, stop using the medication and contact your doctor.

  • Eye makeup or topical creams should be avoided at all times when administering this treatment.
  • You may need to protect your eye(s) from the light – be sure your sunglasses or eye shields are clean and germ free.

Read the directions for handling the dispensing container or bottle – it may require you to shake and mix the contents before administering. Instil the drops per product according to the instructions:

  1. Always wash your hands with soap and warm water before touching the medication or your eye area.
  2. Check the medicine to make sure it has not changed color before administering.
  3.  Tilt your head back and gently pull the lower lid downward
  4.  Allow one drop at a time to enter the eye area
  5.  DO NOT allow the dropper to touch the eye at any time – doing so can contaminate the medication.
  6. Keep your eye open - try not to blink for at least 30 seconds.
  7. Gently close your eyes and rotate your eyes to allow the medicine to be absorbed.
  8. You may need to repeat these steps depending on the dosage prescribed by your doctor.
  9. Do not rinse the top or cap of the bottle.
  10. Secure the cap back onto the bottle.

In all cases, you need to remove your contact lenses. You may need to consult with your doctor over whether you can wear contact lenses during the duration of treatment - depending on the severity of the situation.

If you have been prescribed ointment along with drops, always administer the drops first. Wait at least five minutes between treatments when multiple medicines are necessary.

Treatment durations are typically two weeks. You should continue using the medication even if you feel better. Your doctor will provide instructions on continuing treatment. If the conditions worsen, see your doctor.

DO NOT share medications with others.

This medication is prescribed for your current condition. Any changes or repeat occurrences may require a different treatment and a change in dosage. Use the treatment in the eye being treated only.

DO NOT double your dose in an attempt to catch up or speed up the recovery.

If you miss a dose, resume as soon as possible. Treatment is based on sequences, allowing your body to absorb the medication and process the content in order to cure the condition. Using NSAIDs for a short amount of time is generally safe – although there may be serious side effects with extended use or higher dosages. If you do experience higher levels of pain or a change in your health, contact your doctor.

Interactions

It is critical to provide your doctor with as much information as possible on your medical history, pertaining to the current medications you are taking, any known allergies or reactions to specific types of medicine. We tend to forget that over-the-counter medicines are in fact medications, so are herbal products or therapies. Supplements that you routinely consume can also affect how your body reacts with newly introduced medications. Your doctor will want to monitor your reactions while being treated.

Other interactions to NSAIDs, Ophthalmic:

  • Ibuprofen (Advil, Motrin),
  • Naproxen (Aleve, Naprosyn)
  • Tolmetin (Tolectin)
  • Any medication with the same ingredients in eye drops

So many times, we use home remedies or over-the counter products without knowing the interactions they may have with other drugs or non-prescription medications. Your doctor is looking for blood thinners, pain relievers or fever reducers, which could upset the balance between the volume of doses, increasing your risk of triggering serious medical conditions such as heart attack or stroke.

This may not be all of the potential health conditions to interact with NSAIDs:

  • Immune suppression
  • Congenital infections
  • Scleroderma
  • Osteoporosis
  • Systemic fungal infections
  • Ocular
  • Herpes simple
  • Alcohol
  • History of peptic ulcer
  • Congestive heart failure
  • Hypertension
  • Adrenocortical insufficiency

The interactions could cause:

  • Glucose tolerance
  • Blood pressure
  • Behavioral or mood changes
  • Changes in appetite
  • Weight gain
  • Nasal congestion

Warnings

The danger of NSAIDs is not new, but recent research reports them as the most common pain relievers in the world. They are effective and successful at reducing pain temporarily, but they do increase the risk of other health disorders. Over-the-counter NSAIDs are generally lower in dosage compared to prescription medications, yet they can be just as dangerous to your overall health. This medication should not be used without the consent of your doctor when you are being treated for other health or medical conditions.

It is important to share your sensitivities and medical history with your doctor and pharmacist, especially if you experience asthma – this medication may worsen your breathing or instigate a runny or stuffy nose.

If you have a history of bleeding problems, have undergone eye surgery or have other eye problems such as dry eye syndrome, corneal problems, arthritis, nasal polyps – your doctor needs to know. In some instances, your vision may be temporarily unstable while being treated with this drug. Take precautions when operating vehicles, machinery or activities that require clear vision.

If you are pregnant or in the process of trying to conceive a child, talk with your doctor about the risks of miscarriage or the difficulties of getting pregnant. If you are breastfeeding, be aware that the drug may be passed to the infant through nursing - consult with your doctor before starting this treatment.

NSAIDs, like other medications, are intended to help our bodies heal and recover from health ailments – but there are dangers when taking NSAIDs for an extended period. These dangers could include gastrointestinal tract and kidney related disorders with possible threats to your esophagus and small intestine. Bleeding or peptic ulcers are caused by NSAIDs with no regard for age.

NSAIDs are known to cause fluid retention – termed as edema, which causes an excess of fluid to build up in the body’s tissues. Sever swelling in the head and neck areas can lead to more serious medical conditions. Prolonged use may produce cataracts, glaucoma and secondary ocular infections.

They also effect the body’s process to retain more sodium leading to a reduction in kidney functions. If you have a family history of chronic kidney disease, you need to speak with your doctor. Young children or teenagers are more susceptible to the dangers of NSAIDs.

High doses have been known to cause brain damage or fatal liver disease.

Major Precautions

  • Content percentages could cause allergic reactions
  • Healing process may be delayed
  • Cross-sensitivity to other NSAIDs
  • Platelet aggregation
  • Ocular tissues susceptible to bleeding
  • Inflammation of the cornea
  • Adverse cornea reactions with continued use
  • Loss of vision
  • Caution with diabetes
  • Complications with ocular surgeries
  • Ocular surface disease
  • Corneal epithelial defects
  • Caution with rheumatoid arthritis

Storage

NSAIDs should be kept in the refrigerator (do not freeze) or at room temperature and away from light or moisture. Keep the medication in the container it came in and make sure the caps are tightly closed to prevent moisture or excess heat from entering. Keep it out of the reach of children or pets at all times.

Do not flush any unused portions and DO NOT dispose of medications through community trash disposal. Contact your local hospital or pharmacy for details on how to safely discard unwanted medications. Most facilities have a take-back program for proper disposal.

Summary

Ophthalmic anti-inflammatory drugs are formulated to be applied into the eyes – helping to reduce the pain and treat the inflammation associated with after surgery health conditions and pain. Our bodies naturally go into a defense mode after a medical procedure and sometimes inflammation, irritation or swelling in the eyes occurs – NSAIDs work against these elements, allowing the body to heal. In some cases, a person’s sensitivities can interfere with the healing process.

If an individual is currently being treated for other health conditions, a reaction between the two medicines can trigger other health issues or worsen the current condition being treated.

Resources
Last Reviewed:
December 24, 2017
Last Updated:
February 09, 2018
Content Source: