Sodium Chloride (Ophthalmic)

Ophthalmic sodium chloride solution is used to reduce swelling of the cornea. It works by drawing excess fluids out of the cornea.

Overview

The eye has an outer layer, the cornea, which is transparent and covers the colored iris. The cornea consists of thin layers of tissues that focus the light going into the eye. The innermost layer, the endothelium, is responsible for keeping the cornea clear by constantly pumping away excess fluids. When fluids start to build up, the cornea swells, creating a condition known as corneal edema.

Early symptoms of corneal edema are cloudiness, distortion, blurred vision and haloes around points of light. These conditions can occur most often in the morning and will usually disappear during the day. People over the age of 50 are more likely to develop abnormal swelling of the cornea. Other symptoms include eye pain, sensitivity to foreign particles and photophobia.

If not treated, corneal edema could lead to more pain and blisters that could develop on the surface of the eye. Eventually, the swelling could rupture the corneal nerves and cause even more severe pain. When a patient begins to develop problems with vision, they should consult with their doctor to identify the exact cause of the problem.

Mild cases of corneal edema can usually be treated with a hypertonic sodium chloride solution. This is a concentrated saline solution and is applied as eye drops. The salt in the medication draws the fluid out of the cornea and into tears, which can be wiped away. This reduces the swelling of the cornea and improves vision.

More severe cases of corneal edema have several causes. Swelling can result from cataract surgery, deterioration of endothelium cells or infectious agents, such as herpes. In the most serious cases, such as irreversible damage to the cells of the endothelium, a corneal transplant may be required.

While hypertonic sodium chloride solution is available over-the-counter without a prescription, it is recommended that this medication is used under the direction of an eye care doctor.

Conditions Treated

  • Corneal edema-swelling of the cornea
  • Redness of the eye
  • Irritation

Type of Medicine

  • Hypertonicity agent

Side Effects

You may experience temporary blurred vision, redness, burning sensations, and general eye discomfort. These conditions should be temporary, but, if they persist or get worse, you should contact your doctor immediately. When your doctor prescribed this medication, he made a professional judgment that the possible side effects of the treatment were more tolerable than allowing the swelling of the cornea to continue. Most people using this hypertonic sodium chloride solution do not experience any side effects. Serious reactions to this saline solution are rare.

However, you should seek immediate medical attention if you notice any of these symptoms of a severe allergic reaction:

  • Itching
  • Rash
  • Hives
  • Swelling of the face, throat or tongue
  • Blistered or peeling skin
  • Severe dizziness
  • Difficulty breathing
  • Wheezing
  • Tightness in the chest
  • Hoarseness

This is not a complete list of the possible side effects. If you develop any other unusual reactions, you should contact your doctor at once.

If the swelling has not gone down within three days, you should contact your doctor. Be aware that the application of this medication will only have a temporary effect on reducing the swelling of the cornea. You should discuss a regular schedule with your doctor and develop a plan for long-term treatment.

Dosage

Hypertonic sodium chloride solution is intended for use as eye drops. The directions for frequency and the number of drops should be at the advice of your doctor, or you can follow the instructions on the package.

If you wear contacts, they should be removed before using eye drops. You should wait at least 15 minutes after using the drops before replacing your contact lenses.

Wash your hands before applying the eye drops. Tilt your head back and pull the lower eyelid down to make a pouch. Hold the dropper directly above your eye and squeeze one drop into the pouch. Slowly release the lower eyelid, and close your eyes. Now, place a finger near your nose at the corner of your eye. Apply slight pressure and hold for one to two minutes. This keeps the eye drops from running out. Do not rub your eyes or blink. Repeat these steps if you are applying more than one drop.

Do not clean the dropper after application. Just replace the dropper and cap of the bottle after each use. Use a tissue to remove any excess solution around the eye. Wash your hands to remove any solution that may have spilled onto them. If you are going to apply another type of medication afterward, wait a minimum of five minutes before using the other medication.

If your doctor has established a regular application schedule, and you miss a dose, apply it as soon as you remember. If the time is close to the next application, skip the missed dose and pick up with your regular schedule. Do not take double doses to catch up.

This saline solution could cause harm if swallowed. If someone has swallowed the medication, overdosed or is exhibiting serious reactions, call a local poison control center immediately.

Interactions

All drugs interact with each other in some way when taken at the same time. These interactions can change the effects of each drug, sometimes producing unexpected results. One medication might cause another drug to be totally ineffective or it may lead to a dangerous reaction in the patient. This is why it is important for each person to keep an up-to-date list of all medications he is currently using. This list should be very specific. It should include the exact medical term for the drug, the dosage and the frequency of use. Some patients do not think this detailed information is important and do not provide complete data to their doctor. This is a mistake. Your doctor must know about every type of medication you are taking, including all non-prescription drugs. A doctor has knowledge about the composition of medications and will be alert to any combinations that could lead to a serious reaction.

Sodium chloride ophthalmic solution does not have any known adverse drug interactions. If your doctor has prescribed this medication for you, then he will already be aware of your medical history, any drugs you are currently taking and any possible side effects that may occur. You should not alter your dosage before discussing any changes with your eye care physician or pharmacist.

Warnings

The early symptoms of corneal edema are similar to those produced by cataracts. A doctor must perform an ocular evaluation to make an accurate diagnosis of the problem. He has several procedures at his disposal to make this analysis: optical pachymetry, specular microscopy, and ultrasound.

Fuch's dystrophy is the most likely cause of corneal swelling. It is an inherited disorder and results in the gradual destruction of endothelial cells. Women have a higher risk of endothelial dystrophy compared to men.

Cataract surgeries are the most common source of eye surgeries that could lead to corneal edema. Other causes are viral infections, changes in ocular pressure, toxins, traumatic injury, and dehydration.

The cause of the edema will determine the type of treatment. If ill-fitting contacts are the problem, then new contacts would be the solution. Swelling that results from previous eye surgery could require the use of antibiotics and anti-inflammatory medications. There is no medical procedure or medication that will repair the destruction of the endothelial cells. Nevertheless, mild swelling of the cornea can be controlled.

Before using a sodium chloride ophthalmic solution, tell your pharmacist or doctor if you have any allergies or if you believe you might be allergic to a saline solution. This medication contains a number of inactive ingredients which could cause an allergic reaction. Discuss the details of the formulation with a pharmacist to determine if any of these inactive ingredients might cause a reaction.

Review the following inactive ingredients with your eye doctor for any possible allergies you may have:

  • Boric acid
  • Hypromeliose
  • Propylene glycol
  • Sodium borate
  • Hydrochloric acid
  • Sodium hydroxide
  • Methylparaben
  • Propylparaben

Before using a saline solution, the patient should make sure that his or her doctor has a complete medical history and is aware of any current health problems.

This product is safe for women to use during pregnancy. However, information is not available on the effects of a sodium chloride solution on breast milk. You should discuss this situation with your doctor before using it during breastfeeding.

Storage

The product should be stored upright in temperatures ranging from 68 to 77 degrees F. The cap should be replaced after each use, and it should be kept tightly closed. To avoid the possibility of contamination, do not let the tip of the container touch any other surface. It should not be stored in the bathroom. The container should be placed in an area that is protected from light and moisture. It should not be frozen.

Do not flush this medication down the toilet or pour into a drain. It should be properly disposed of when it has reached expiration date or is no longer needed. Keep this product away from children and pets. Discuss the proper disposal procedures with your pharmacist or a local waste management company.

Summary

Sodium Chloride-hypertonic ophthalmic is a common and simple treatment for mild cases of swelling of the cornea. While it is available over-the-counter, it should still be taken under the supervision of a doctor. He is the medical professional who will be most aware of his patient's medical history, allergies and the proper dosage to use. This saline medication does not have any known drug interactions and is safe for women to use during pregnancy.

This medication is applied as eye drops and is fairly easy to use any time a patient notices blurred vision or haloes. However, be aware that the need for continuous use indicates more serious medical problems exist in the cornea and further action, such as a cornea transplant, may need to be taken.

When someone has vision problems, the most important step to take is to consult with an eye care doctor. Most of the time, these problems can be treated with over-the-counter medications, but the patient should rely on his doctor to make these recommendations and not make these decisions himself. There are multiple causes of corneal edema, and proper treatment depends on the results of a professional examination.

 

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Last Reviewed:
January 30, 2018
Last Updated:
February 10, 2018