II. Indications
- Treatment of infection
- Prophylaxis in Eye Injury (avoid Aminoglycosides due to toxicity risk)
- Corneal Abrasion
- Chemical Eye Burn
III. Preparations: Most cost effective agents
- First-line
- Trimethoprim-Polymyxin B (Polytrim) solution
- Erythromycin 0.5% ointment
- Broad-spectrum
- Gentamicin (Gentak) 0.3% ointment or solution
- Tobramycin (Tobrex) 0.3% solution (ointment is not generic and is expensive)
- Ciprofloxacin (Ciloxan) 0.3% ointment or solution
- Ofloxacin (Ocuflox) 0.3% solution
IV. Preparations: First-Line general purpose
- Trimethoprim-Polymyxin B (Polytrim) solution
- Sulfacetamide 10% (Bleph-10) ointment or Solution
- Typically avoid due to low efficacy and reaction risk
- Bacitracin ointment (used in stye)
V. Preparations: First-Line Macrolides (especially if Chlamydia suspected)
- Erythromycin 0.5% ointment
- Azithromycin 1% (Azasite) solution
VI. Preparations: Broad-Spectrum Fluoroquinolones
- Precautions
- Reserve for severe infections to prevent resistance
- Besifloxacin (Besivance) 0.6% solution
- Ciprofloxacin (Ciloxan) 0.3% ointment or solution
- Gatifloxacin (Zymar) 0.3%
- Levofloxacin (Iquix) 1.5% or (Quixin) 0.5% solution
- Moxifloxacin (Vigamox) 0.5% solution
- Ofloxacin (Ocuflox) 0.3% solution
VII. Preparations: Broad-spectrum Aminoglycosides
- Precautions
- Reserve for severe infections to prevent resistance
- Avoid if Corneal Injury (toxicity risk)
- Gentamicin (Gentak) 0.3% ointment or solution
- Tobramycin (Tobrex) 0.3% ointment or solution
VIII. Preparations: To Avoid
- Neomycin (topical reactions are common)