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However, it is important that we are all aware of this research— that’s why we read the journals! • Topical antibiotics play a very limited role in contemporary eye care, as their only indication is for the treatment of bacterial infection, which is relatively uncommon as compared to inflammatory eye conditions.7 There are three prime uses for antibiotics: − children with bacterial conjunctivitis − prophylaxis when using a bandage contact lens − bacterial corneal ulcers When we encounter adults with acute bacterial infections, we treat with a combination antibiotic-steroid such that we address the infection and the secondary inflammation simultaneously. For more advanced bacterial infections, we most commonly prescribe generic moxifloxacin or Besivance. Note that Besivance is an THE BENEFITS OF DRINKING WATER “Clinicians should use simple, clear messaging on the role of water as the primary drink for all children, adolescents, and young adults when discussing healthy habits with families.” Rosinger AY, Bethancourt H, Francis LA. Association of caloric intake from sugar-sweetened beverages with water intake among us children and young adults in the 2011-2016 National Health and Nutrition Examination Survey. JAMA Pediatric. 2019;173(6):602-04. SECTION I: STRATEGIES FOR SUCCESS YELLOW-TINTED GLASSES AND NIGHT DRIVING • “Wearing yellow-lens glasses did not improve (i.e., more likely worsened) performance either with or without headlight glare.” • “These findings do not appear to support having eye-care professionals advise patients to use yellow-lens night-driving glasses.” —JAMA Ophthalmol., August 2019 REVIEW OF OPTOMETRY JUNE 15, 2020 11 ophthalmic suspension and needs to be shaken before each instillation. For this reason, when used for prophylaxis in the setting of a bandage soft contact lens, we would choose generic moxifloxacin, since it is a solution. For corneal ulcers, we would use besifloxacin because of it superiority as demonstrated in the ARMOR study (see p. 29 for the 2020 ARMOR data). • Some patients with migraine headaches, blepharospasm and postconcussion suffer from quality-of-life –altering photophobia. An FL-41 (FL stands for fluorescent) spectacle lens coating can filter out certain wavelengths of blue/green light that have been shown to contribute to light sensitivity.8 Of course, it is important to rule out ocular surface disease, so conduct a trial of topical corticosteroids QID for two weeks to address any inflammatory component before suggesting FL-41 coating. Addressing severe photophobia may require multiple approaches, but do be aware of such options. • Steroids are simple: we prescribe Durezol (Novartis) for advanced cases of anterior uveitis and episcleritis; for everything else, we prescribe Lotemax SM (Bausch + Lomb). As emulsions, neither require shaking prior to instillation. There are times when regulatory formularies limit us to generic prednisolone acetate, which must be shaken well before each use. • Regarding eyedrops, we ourselves personally demonstrate to our patients how to properly instill these agents: with the face looking at the ceiling while pulling down the lower eyelid, and having the bottle tip about a half-inch away from the eye.
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