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Ophthalmic drugs

This VRICS assesses the practitioner’s ability to identify ophthalmic drugs, understand their clinical use, mechanisms of action and contraindications, and recognise the legislation governing their supply

Image A

Image A

01 Which of the following terms does not describe the action of the ophthalmic drug shown in the image?

a) Anticholinergic
b) Muscarinic antagonist
c) Nicotinic agonist
d) Parasympatholytic

02 The risk of side effects from instilling the ophthalmic drug shown may increase with concomitant use of which of the following systemic medications?

a) Amantadine
b) Antihistamines
c) Tricyclic antidepressants
d) All of these options

03 Which of the following is not a known potential side effect of the ophthalmic drug shown in the image?

a) Central nervous system disturbances
b) Conjunctival oedema
c) Raised intraocular pressure
d) Posterior subcapsular cataracts

Image B

Image B

04 The types of ophthalmic drugs shown in the image are used for what clinical purpose?

a) Corneal anaesthesia
b) Reduction of intraocular pressure
c) Reduction of ocular inflammation
d) Vital staining of the anterior ocular surface

05 Which of the following statements is correct with regards to the mechanism of action of the drug type shown in the image?

a) They bind to effector sites in the iris sphincter muscle preventing the action of acetylcholine
b) They stimulate the action of noradrenaline on the iris dilator muscle
c) They act on nicotinic receptors on the iris sphincter muscle
d) They act as an antagonist on voltage-gated sodium channels

06 Which of the following ophthalmic drugs would have a molecular structure such as that shown in molecule 2 of the image?

a) Dexamethasone
b) Lidocaine
c) Lissamine green
d) Tetracaine

Image C

Image C

07 Which ophthalmic drug has been instilled in the right eye of the patient shown in the image?

a) Atropine
b) Cyclopentolate Hydrochloride
c) Phenylephrine Hydrochloride
d) Pilocarpine

08 Which of the following terms does not describe the drug instilled in the image?

a) α1 adrenergic receptor agonist
b) Mydriatic
c) Muscarinic M3 receptor agonist
d) Sympathomimetic

09 Which of the following statements is incorrect with regards to the drug instilled in the image?

a) Instillation of the drug is contraindicated in patients with asthma
b) The use of 10% preparations in neonates and adults over 65 years is recommended
c) Instillation in patients taking antihypertensive medications is potentially fatal
d) It is classified as a ‘P’ medicine

Image D

Image D

10 Which ocular pathology does the OCT in the image show?

a) Macular hole
b) Retinitis pigmentosa
c) Toxoplasmosis
d) Wet macular degeneration

11 Which of the following drugs could be used to treat the pathology shown?

a) Acrivastine
b) Moxifloxacin
c) Ranibizumab
d) Rimexolone

12 How is the drug used to treat the pathology shown administered to the eye?

a) Intrachoroidally
b) Intravitreally
c) Subconjunctivally
d) Subtenon

About the authors

Dr Fiona Cruickshank PhD, MCOptom is an optometrist and post-doctoral research associate at Aston University where she also teaches clinical skills to undergraduate optometry students.

Professor Leon Davies PhD, FCOptom, FAAO, SFHEA is head of optometry and a professor in optometry and physiological optics at Aston University. He is a previous clinical editor of Optometry Today and is currently an editorial board member of the College of Optometrists’ CET journal Optometry in Practice. Professor Davies holds fellowships with the College of Optometrists, the American Academy of Optometry and a senior fellowship with the Higher Education Academy.