What are the key counseling points for patients using ketorolac (nonsteroidal anti-inflammatory drug (NSAID)) eye drops?

Key Counseling Points for Ketorolac Eye Drops

Patients using ketorolac eye drops should be instructed on proper administration technique, including nasolacrimal occlusion for 1-2 minutes after instillation to reduce systemic absorption and increase effectiveness. 1

Administration Technique

• Apply one drop (0.25 mg) four times a day as prescribed 2
• Administer at a 45-degree angle to produce smaller, more economical drops that better approximate the volume of the lacrimal lake 1
• Press finger against inner corner of eye (nasolacrimal occlusion) for 1-2 minutes after instillation to:
  • Reduce systemic absorption
  • Increase ocular contact time
  • Enhance therapeutic effect 1
• Wait at least 5 minutes between different eye medications if using multiple types 1
• Link administration to daily activities to improve adherence 1

Handling and Storage

• Wash hands before handling eye drops to prevent infection 1
• Do not touch the tip of the bottle to any surface, including the eye, to maintain sterility 1
• Keep eye drops away from water to prevent contamination 1
• Discard multiple-dose eyedrop containers after inadvertent contact with the ocular surface 1

Expected Effects and Monitoring

• Ketorolac is an NSAID that reduces inflammation and relieves ocular itching 3, 2
• Patients should understand that:
  • Relief may be slightly delayed compared to some other medications 4
  • A fixed four-times-daily dosing schedule provides better symptomatic relief than as-needed use 1
  • The medication works by reducing prostaglandin production involved in mediating ocular allergy 3

Important Warnings and Precautions

• Alert patients with known aspirin or NSAID allergy to avoid ketorolac eye drops 5
• Patients with asthma and nasal polyps should be cautioned about potential risk of asthma exacerbation 5
• Inform patients that ketorolac can be safely administered with other ophthalmic medications such as antibiotics, beta blockers, carbonic anhydrase inhibitors, cycloplegics, and mydriatics 2

When to Contact Healthcare Provider

• Instruct patients to contact their healthcare provider if:
  • They experience significant eye pain, redness, or vision changes
  • Symptoms worsen or do not improve after using the medication as prescribed
  • They develop any signs of allergic reaction (itching, swelling, difficulty breathing)

Special Considerations

• For patients with moderate to severe dry eye, discuss with their doctor about adding or switching to other therapies if artificial tears alone do not provide sufficient relief 1
• Patients should be informed that ketorolac eye drops may be used for various conditions including:
  • Relief of ocular itching due to seasonal allergic conjunctivitis
  • Treatment of postoperative inflammation after cataract surgery
  • Management of pseudophakic cystoid macular edema 2, 6

By following these counseling points, patients can maximize the effectiveness of ketorolac eye drops while minimizing potential adverse effects.