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Alaska Blind Child Discovery

A cooperative, charitable research project to vision screen every preschool Alaskan
 

Eye Drops for Children

 
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What is the best antibiotic eye drop for children? The answer is "That depends." ideally the drop works quickly on the offending microorganism (bacteria, virus, fungus or protist), is well tolerated by the eye and lids, does not sting when instilled, kills pathogens with a minimum of drops and is well tolerated by the family (general health of baby, acceptance by mom, cost, etc). Leading pediatric ophthalmologists have found great success with dilute (1.5%) iodophore (Betadine) being inexpensive and effective for nonatal and infant eye infections worldwide- the tast is bitter, however. ABCD does not prefer drops / oitments that hurt or sting due to poor pH, that causes frequent allergy (sulfa and neomycin), or delays corneal healing (gentamicin). ABCD prefers antibiotics that kill germs (-cidal) instead of just slowing germs down (-static). Part of an eye drop goes to /in the eye whereas the rest flows down the tear duct through the nose and is ingested. An infant weighing 3 Kg ingests the same amount of eye drop as does a 70 Kg adult therefore it is particularly important to consider systemic side effects like adrenal suppression (combinations with corticosteroids), diarrhea and even taste.
 
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ulcer Infant with corneal ulcer One of the most serious eye infections in children is bacterial corneal ulcer by organisms such as Pseudomonas auriginosa which can perforate the eye in less than 12 hours! This Alaskan infant got just such an infection despite treatment with a generic antibiotic oitment for a suspected corneal abrasion. 12 hours later mucopurulent dischage covered the cornea and had entered the eye. Frequent state-of-the-art cataract surgeon drops (Zymar- Allergan) were started after initial surgery. Mom noticed that the infant was very reluctant to breat feed. A taste-test demonstrated that the other state-of-the-art fluoroquinolone drop (Vigamox, mofifloxacin, Alcon) tasted much better than Zymar. Shortly after switching to Vigamox every hour, the infant readily resumed breast-feeding. unfortunately, cost saving on the initial generic ointment resulted in a very expensive course of therapy including two corneal transplants- the baby retained the eye.
Vigamox Taste Zymar
 
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