Diclofenac (ophthalmic)

Overview

Used to treat pain and reduce inflammation, Diclofenac is available in various formats. When prescribed as an ophthalmic solution, this medication is used to treat patients who have recently undergone eye surgery. Following cataract surgery, for example, patients may experience swelling of the eye and/or pain. Diclofenac eye drops work to relieve the pain and reduce the associated swelling, thus minimizing the patient's recovery time.

In addition to this, Diclofenac eye drops can be given to patients who have undergone corneal refractory surgery. When prescribed in this instance, Diclofenac helps to relieve photosensitivity and temporary post-operative pain.

By inhibiting cyclooxygenase, Diclofenac also prevents prostaglandin synthesis and this is what gives the drug its analgesic and anti-inflammatory properties. Rather than simply taking painkillers to reduce pain after eye surgery, patients can use Diclofenac eye drops to reduce swelling and minimize irritation.

Conditions Treated

  • Post-operative pain and swelling

Type Of Medicine

  • Non-steroidal anti-inflammatory drug (NSAID)

Side Effects

When using Diclofenac ophthalmic solution, patients may notice some burning or stinging in the affected eyes. Although this is not uncommon, patients should contact their physician if the pain is extreme or if it is prolonged. The following side effects may also occur after using Diclofenac ophthalmic solution:

  • Stomach or abdominal pain
  • Chills
  • Dizziness
  • Cold or flu-like symptoms
  • Hoarseness or cough
  • Fever
  • Loss or lack of strength
  • Headache
  • Nausea
  • Runny nose
  • Pain
  • Sleeplessness
  • Inability to sleep
  • Sneezing
  • Trouble sleeping
  • Stuffy nose
  • Puffiness or swelling of the face
  • Vomiting

While the side-effects listed above are not particularly common, they aren't usually a cause for concern either. While patients don't usually suffer from these adverse effects when using Diclofenac eye drops, they tend to be fairly mild when they do occur.

There are some side effects which require medical attention, however. These include:

  • Eye pain, irritation or redness
  • Blindness
  • Tearing of the eyes
  • Blurred vision
  • Yellow or clear fluid from the eye
  • Itching, dry or burning eyes
  • Change in vision or decreased vision
  • Sensitive to light
  • Swelling, pain or redness of the eyelid, eye or inner lining of the eyelid
  • Matted or sticky eyelashes
  • Feeling of something in the affected eye
  • Throbbing pain

Patients should also seek medical advice if they experience any adverse effects which are not listed here. In addition to this, patients can report any other side effects to the Food and Drug Administration, if they choose to. This helps the FDA to maintain up-to-date information about the possible side effects which may occur when patients are using Diclofenac ophthalmic solution. Patients can report these side effects to the FDA by calling them on 1-800-FDA-1088.

Dosage

Following surgery, patients will receive specific aftercare advice. It is important that patients follow this advice carefully so that the effects of surgery are maintained. When Diclofenac ophthalmic solution is prescribed, patients will also be told when to use it and how much solution should be applied.

Generally, patients using Diclofenac eye drops after cataract surgery will be advised to use just one drop in the affected eye, four times per day. In most cases, patients will be told to start applying the eye drops 24 hours after their surgery has taken place. After cataract surgery, patients may be advised to use Diclofenac eye drops for a period of up to two weeks.

If patients have undergone corneal refractory surgery, however, the standard dosing instructions may be one or two drops in the affected eye within an hour before the surgery takes place. Following this, patients may be advised to apply one or two drops in the affected eye within 15 minutes of the surgery taking place. Patients may then be told to apply Diclofenac eye drops four times per day, for a period of three days.

If patients routinely wear contact lenses, they should remove them while using Diclofenac ophthalmic solution. Their surgeon or ophthalmologist may also provide specific instructions regarding the use of contact lenses and/or glasses following eye surgery.

When applying Diclofenac eye drops, patients should wash their hands thoroughly and gently press on their lower eyelid. This moves the eyelid away from the eye and creates a space in which the eye drops can be administered.

Patients should drop the appropriate amount of medication into this space and close their eye. If possible, patients should refrain from blinking and keep their eye closed. Applying gentle pressure to the inner eye for approximately one or two minutes will allow the Diclofenac eye drops to reach all areas of the eye and be most effective.

Immediately after use, patients should close the medicine container tightly, ensure it is stored safely and wash their hands thoroughly. It is vital that patients do not allow the applicator to come into contact with any other surfaces, including their eye or their hands. This helps to keep the medication free of germs and reduces the risk of an infection occurring. If bacteria is allowed to get into the medication, it could become contaminated and this could put the patient at risk of serious vision problems and damage to their eye.

If patients forget to administer a dose of Diclofenac ophthalmic solution, they should do so as soon as they remember. However, if the next dose of medicine is almost due, patients should skip the missed dose completely and continue with their normal medication schedule. If patients are unsure how to do this, they should contact their doctor or pharmacist for advice.

Although these are standard dosing and application instructions for Diclofenac ophthalmic solution, patients should follow the instructions set out by their doctor. As every patient is different, it is important for patients to adhere to their unique treatment plan.

Warnings

As some medications can interact with other substances, patients should tell their physician if they are taking any other medicines before using Diclofenac ophthalmic solution. This includes over-the-counter medications, supplements and/or vitamins. If patients purchase any of these substances following their surgery, they should obtain medical advice before using them alongside Diclofenac eye drops.

Patients should discuss their medical history with their surgeon prior to any procedure being carried out. If patients have certain medical conditions or have undergone certain procedures, it may affect the suitability of Diclofenac ophthalmic solution as a treatment for them. These include:

  • Rheumatoid arthritis
  • Multiple eye surgeries within a short timeframe
  • Complicated eye surgeries
  • Corneal denervation
  • Eye surface diseases
  • Bleeding problems
  • Corneal epithelial defects
  • Diabetes
  • Allergy to phenylacetic acid, aspirin or other non-steroidal anti-inflammatories (NSAIDs), such as naproxen, ibuprofen etc.

Even patients who have undergone the procedures listed above or who have been diagnosed with any of the conditions listed above may still be prescribed Diclofenac eye drops. However, physicians may alter the dose of their medication or monitor them more often to ensure that no adverse effects are caused by the medication.

Generally, pediatric patients are not prescribed Diclofenac ophthalmic solution as the efficacy and safety of this medicine for younger patients has not been confirmed. If the potential benefits clearly outweigh the risks, however, physicians may prescribe Diclofenac eye drops to younger patients.

If patients do not notice an improvement in their condition within a few days of using Diclofenac ophthalmic solution, they should contact their physician for advice.

In some cases, Diclofenac eye drops can slow down the rate at which the patient heals. Patients should discuss this with their doctor if it is relevant to them, particularly if they are also using topical corticosteroids or other medications.

For some patients, using Diclofenac ophthalmic solution could increase the risk of other eye problems occurring. If patients notice any of the following symptoms they should stop using the eye drops and contact their physician immediately:

  • Pain in the eye
  • Irritation
  • Blurred vision
  • Eye redness
  • Changes in vision

However, it is not uncommon or dangerous if stinging or burning occurs when the solution is first applied.

If a patient is pregnant, they may not be prescribed Diclofenac eye drops. Prescribing this medication to patients who are pregnant may carry some risks, particularly if they are in the third trimester of their pregnancy. As Diclofenac eye drops affect prostaglandin biosynthesis, this could have an unwanted effect on the fetal cardiovascular system, particularly if it is used in the latter part of the pregnancy. Due to this, Diclofenac eye drops are not usually prescribed to patients who are pregnant.

Pregnant patients should notify their physician before using Diclofenac ophthalmic solution or undergoing any medical procedures.

If patients become pregnant whilst using Diclofenac eye drops, they should contact their physician for advice.

It is not known whether Diclofenac ophthalmic solution could affect an infant if the patient breastfeeds whilst using this medication. Due to this, patients are usually advised not to breastfeed whilst using Diclofenac eye drops. Patients should always consult their physician before breastfeeding whilst using or taking any medications.

Following surgery and whilst using Diclofenac eye drops, patients will need to attend regular appointments with their physician. This will ensure that the medication is working as it should and that no adverse effects are occurring.

Before using this medication, patients should notify their physician of any allergies they have. If patients experience any allergic reaction whilst using Diclofenac ophthalmic solution, they should seek immediate medical attention. Symptoms of an allergic reaction can include itching, hives, swelling of the eyelids, throat or tongue, difficulty breathing and wheezing. Although this is rare, it does constitute a medical emergency.

Storage

When patients are prescribed Diclofenac ophthalmic solution they will be expected to apply the medication at home, rather than in a clinical setting. However, patients will need to take steps to ensure that the medication can be stored in a safe location and that it won't be accessible to pets and/or children.

Generally, Diclofenac eye drops should be kept at room temperature and away from moisture, heat and light. Patients should, however, read the medication guide and follow the relevant storage instructions when they take their medicine home.

If patients are advised to stop using Diclofenac ophthalmic solution they will need to dispose of the medicine carefully. Similarly, if the medicine reaches its use-by date, patients will need to throw it out. Using out-of-date medication could be harmful and is never recommended.

Rather than throwing medicine away with normal household waste, patients should seek advice from their pharmacist of their physician's office. Normally, specialist medical waste services are available so that patients can dispose of unused medication safely.

Summary

As patients can experience pain, inflammation and/or swelling after eye surgery, it's important that physicians are able to minimize these symptoms and prevent the patient from suffering unnecessarily.

By prescribing Diclofenac ophthalmic solution, doctors can help to prevent the patient from experiencing pain, as well as reducing any swelling or inflammation which might be present. Due to this, they are the first-choice medication for patients who have had cataract or corneal refractory surgeries.

Although Diclofenac eye drops are normally only prescribed for short-term use, they provide effective relief from post-operative pain and discomfort when patients have undergone certain types of eye surgeries. Easy to administer and appropriate for use by the majority of patients, Diclofenac eye drops enable individuals to have a more comfortable recovery period following surgery.