Ocular Pharmacology Flashcards

Which anti-VEGF agent is FDA-approved for neovascular (wet) AMD treatment by intravitreal injection?

Answer: Aflibercept (Eylea) and ranibizumab both approved

Both aflibercept (Eylea) and ranibizumab (Lucentis) are FDA-approved for neovascular AMD; bevacizumab is widely used off-label due to cost differences.

The mechanism of cyclopentolate in achieving cycloplegia differs from atropine primarily in its:

Answer: Duration of action (shorter: 24 hours vs. 7–14 days)

Both cyclopentolate and atropine are anticholinergic (muscarinic) agents, but cyclopentolate's cycloplegia lasts ~24 hours versus atropine's 7–14 days.

Rose bengal vital dye is used in optometric examination to stain:

Answer: Devitalized and dead corneal/conjunctival epithelial cells

Rose bengal stains devitalized, dead, or mucus-covered cells that lack adequate mucin coating, making it useful for diagnosing keratoconjunctivitis sicca and herpetic disease.

Pilocarpine is used in acute angle-closure glaucoma attack management to:

Answer: Contract the iris sphincter to pull the peripheral iris from the angle

Pilocarpine (a muscarinic agonist) constricts the pupil, mechanically pulling the peripheral iris tissue away from the trabecular meshwork to re-open the drainage angle during an acute attack.

Which preservative in multi-dose eye drops is most commonly associated with corneal toxicity with chronic use?

Answer: Benzalkonium chloride (BAK)

BAK is the most commonly used preservative but is a detergent that disrupts corneal epithelial tight junctions and promotes apoptosis with chronic exposure, especially in glaucoma patients.

Oral acetazolamide (Diamox) used for acute IOP reduction works by inhibiting which enzyme?

Answer: Carbonic anhydrase, reducing bicarbonate-driven aqueous secretion

Acetazolamide inhibits carbonic anhydrase throughout the body, with the dominant ocular effect being reduced bicarbonate and sodium co-transport by the ciliary epithelium, cutting aqueous production by 40–60%.