punctal occlusion
This is a technique used to decrease the absorption of eye drop medications. Normally when you put eye drops in, the medication drains through the puncta, down the nasolacrimal duct, and into the nose. This is why people have a runny nose when their eyes are teary. Unfortunately, the nose absorbs medicines directly into the blood stream (which is why cocaine is snorted and not swallowed). Some of the medicines we use can have significant systemic absorption and can cause side effects. Overall these side effects are rare, but you can perform punctal occlusion to help avoid the absorption. After you put your eye drops in, immediately close your eyes. Don’t blink, as blinking can act as a pump and shoot the medicine right into your nose. Instead, take your fingers and press the bridge of your nose right next to your eyes. Hold this for a good 20 seconds and this will decrease your systemic nose absorption significantly.
Would this apply to use of three tetragenic glaucoma medications used by a 30 year old aphaekic glaucoma who has been on these meds since age five? She is onsidering getting pregnant.
I can’t comment on how teratogenic any eye medications are … to my knowledge, none of them have been properly tested in pregnancy.
I generally try to minimize all ocular medications with pregnant patients. Punctal occlusion certainly sounds like a good method to decrease systemic absorption for any eye medication, no matter what the circumstance.
You should ask your primary eye doctor on what they recommend for you given your specific case.
I am allergic to BAK in dialating drops and post opt eye drops after cateract surgery. I am trying to find out where I can get these drops preservative free or compounded. The eye doctors I have consulted seem clueless. So I am trying to help myself. I know I am not the only person with this problem. Do you know what pharmacies I can contact that does this? Sincere thanks.
You need to find a compounding pharmacy to mix up a preservative-free antibiotic and steroid. Or ask if any nearby surgeons do “dropless” cataract surgery … where they inject a preservative free formula into the eye at the end of your surgery. Here is an example of a pharmacy that could make an antibiotic (tobramycin) and steroid (dexamethasone)