What eye drop is required for treatment?

Eye Drop Requirements for Specific Clinical Conditions

High-Dose Cytarabine Therapy

Saline or steroid eye drops must be administered to both eyes 4 times daily for all patients undergoing high-dose cytarabine therapy, continuing until 24 hours post-completion of cytarabine. 1

• This prophylactic regimen is mandatory to prevent cytarabine-associated ocular toxicity, which can manifest as keratoconjunctivitis 1
• The eye drops should be initiated at the start of high-dose cytarabine and maintained throughout the treatment course 1
• Either saline or corticosteroid formulations are acceptable options 1

Eye Trauma Management

For acute eye trauma, nonpreserved hyaluronate or carmellose eye drops should be applied every 2 hours during the acute phase to maintain corneal epithelial integrity. 2

• Broad-spectrum topical antibiotics (moxifloxacin drops four times daily) are required when corneal fluorescein staining or frank ulceration is present 2
• Topical corticosteroid drops (nonpreserved dexamethasone 0.1% twice daily) may reduce ocular surface damage in the acute phase 2
• Contact lens wearers with corneal trauma require topical antibiotics to prevent acute bacterial keratitis 2

Juvenile Idiopathic Arthritis-Associated Uveitis

Topical glucocorticoid eyedrops (prednisolone acetate 1% or equivalent) are strongly recommended for patients with JIA and active chronic anterior uveitis not currently on systemic therapy. 1

• Initial doses may exceed 1-2 drops/eye/day but should be tapered as inflammation improves 1
• Topical glucocorticoids should be used as short-term therapy ≤3 months due to risk of glaucoma and cataracts 1
• If patients continue to require 1-2 drops/day of prednisolone acetate 1% for 2-3 months, systemic therapy should be added or escalated 1

Dry Eye Syndrome

For severe dry eye, preservative-free artificial tears (hyaluronate or carmellose formulations) applied every 2 hours represent first-line therapy. 1, 3

• Higher percentage hyaluronate formulations offer greater therapeutic efficacy for more severe disease 1
• Autologous serum drops (20% concentration) have demonstrated benefit in Sjögren's syndrome and GVHD-related dry eye 1
• Topical cyclosporine 0.05% should be considered for patients with posterior blepharitis 3

Dupilumab-Related Ocular Surface Disorders (DROSD)

Preservative-free hyaluronate drops applied twice to four times daily are the initial treatment for DROSD, with higher hyaluronate percentages reserved for more severe disease. 1

• If lubricants are ineffective after 4 weeks, olopatadine antihistamine eyedrops twice daily should be added 1
• Tacrolimus ointment shows 89% response rate and represents an effective escalation option 1
• Corticosteroid eyedrops demonstrate 74% response rate but should be used judiciously 1

General Ocular Surface Irritation in Inpatients

Preservative-free artificial tears every 2 hours during the acute phase are recommended as first-line treatment for burning and redness. 3

• For moderate irritation, increase frequency and consider adding topical antihistamine drops if symptoms persist 3
• For severe irritation, continue frequent preservative-free tears and consider short-course topical corticosteroids under supervision 3
• Ophthalmology consultation is warranted if symptoms don't respond within 48-72 hours 3

Critical Considerations

• Preserved eye drops should be avoided in patients requiring frequent application due to preservative toxicity risk 1, 3
• Topical corticosteroids can mask corneal infection signs and increase intraocular pressure; use with caution in corneal epithelial defects 3
• Daily ophthalmological review is necessary during acute illness for severe ocular surface disease 2, 3