Ocular Pharmacology and Medication Administration
What the exam tests
Ocular Pharmacology and Medication Administration tests drug classes, routes, instillation technique, timing and adverse effects. Practical questions focus on dilating drops and safety checks.
Topical drugs
Mydriatics dilate the pupil; cycloplegics also paralyse accommodation. Tropicamide 0.5–1% and phenylephrine 2.5% are short-acting; cyclopentolate 1% and atropine 1% are longer-acting. Topical anaesthetics such as proparacaine 0.5% are for office procedures only and must never be dispensed for home use. Antibiotics, corticosteroids and glaucoma drugs each carry specific risks: timolol can worsen asthma, and latanoprost can darken the iris.
Instillation technique
Check the right patient, drug, dose, eye and expiry. Wash hands, pull down the lower lid, instil one drop into the conjunctival sac without touching the tip to the eye, and apply punctal occlusion for 1–2 minutes. Wait about 5 minutes between different drops. Record the drug, eye and time.
Worked example
A fundus examination is needed for a healthy adult. Reasoning: tropicamide 1% with phenylephrine 2.5% gives pupil dilation in about 20–30 minutes. First check for a shallow anterior chamber or angle-closure risk, then instil the drops, document them and warn about blurred near vision and photophobia.
Traps
Do not use atropine for routine dilation, give a topical anaesthetic to take home, instil drops without checking asthma before a beta-blocker, or touch the dropper tip to the conjunctiva. Do not forget to record which eye received the drug.