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Ophthalmic Drug Delivery Systems

Ophthalmic Drug Delivery Systems

Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...

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Related Experiment Video

Updated: Mar 11, 2026

Author Spotlight: Advancing Research in Corneal Opacity Treatment and Regeneration

Author Spotlight: Advancing Research in Corneal Opacity Treatment and Regeneration

Published on: August 4, 2023

Drug-induced corneal epithelial changes.

Michael B Raizman¹, Pedram Hamrah¹, Edward J Holland²

¹Department of Ophthalmology, Tufts University School of Medicine, Boston, Massachusetts, USA.

Survey of Ophthalmology

|November 29, 2016

Summary

This summary is machine-generated.

Many drugs cause corneal changes like vortex keratopathy or haze due to phospholipid accumulation. Understanding these drug-induced corneal deposits aids management, often without altering therapy.

Keywords:

cornea cornea verticillata epithelium ocular side effects vortex keratopathy whorl keratopathy

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Area of Science:

Ophthalmology
Pharmacology
Cell Biology

Background:

Numerous pharmacologic agents can induce epithelial changes in the cornea.
Cationic amphiphilic drugs, common in many classes, possess structures facilitating cell membrane penetration and intracellular phospholipid accumulation.
This accumulation can manifest as specific corneal opacities, such as vortex keratopathy or diffuse haze.

Purpose of the Study:

To review the diverse range of drugs causing corneal epithelial changes.
To elucidate the various mechanisms underlying drug-induced corneal deposits.
To provide insights into managing patients with these ocular side effects.

Main Methods:

Literature review of pharmacologic agents and their ocular side effects.
Analysis of drug structures and their correlation with corneal epithelial deposition.
Examination of clinical presentations and visual outcomes associated with drug-induced corneal changes.

Main Results:

Cationic amphiphilic drugs often cause vortex keratopathy with minimal visual impact.
Antineoplastic agents may induce a diffuse corneal haze, potentially leading to dose-limiting visual disturbances.
Other drugs can result in crystalline epithelial precipitation requiring intervention.

Conclusions:

Understanding the mechanisms of drug-induced corneal deposits is crucial for effective patient management.
In most cases, therapeutic drug levels can be maintained, but visual impairment necessitates physician collaboration for dose optimization.
Close monitoring is essential, especially when drugs are linked to other ocular toxicities like optic neuropathy or retinopathy.