What is ACULAR and How Does it Work?
ACULAR is the brand name for ketorolac tromethamine ophthalmic solution, a nonsteroidal anti-inflammatory drug (NSAID) specifically formulated for use in the eyes. Unlike oral NSAIDs that affect the entire body, ACULAR is a topical medication, delivering its effects directly to the eye's surface. It works by blocking the production of chemical messengers called prostaglandins.
The Mechanism of Action
Prostaglandins are lipid compounds that act as signaling molecules in the body. In response to injury, surgery, or allergens, the body produces these substances, which cause pain, redness, swelling, and inflammation. By inhibiting cyclooxygenase (COX), the enzyme responsible for creating prostaglandins, ACULAR effectively interrupts this inflammatory cascade, reducing discomfort and other symptoms. This targeted action makes it a crucial tool for managing specific eye conditions.
Key Medical Uses of ACULAR Eye Drops
ACULAR is prescribed by a healthcare provider for several key therapeutic applications.
Treating Post-Operative Inflammation
One of the primary uses of ACULAR is to manage the pain and swelling that often follows eye surgery. Specifically, it is indicated for:
- Cataract extraction: Inflammation, such as cystoid macular edema, is a common post-operative concern after cataract surgery. ACULAR helps control this inflammation, which is vital for proper healing.
- Corneal refractive surgery: Following procedures like photorefractive keratectomy (PRK), ACULAR LS (a specific formulation) is used to manage post-operative pain and inflammation.
Relieving Ocular Itching
ACULAR is also effective for managing the symptoms of seasonal allergic conjunctivitis, commonly known as seasonal eye allergies. During an allergic reaction, certain substances trigger the release of prostaglandins, causing the eyes to become itchy. By blocking these inflammatory substances, ACULAR provides relief from this irritating symptom.
How to Properly Administer ACULAR Eye Drops
Following the correct procedure for instilling eye drops is essential for effectiveness and to prevent contamination. The steps include:
- Wash your hands: Thoroughly wash your hands with soap and water to prevent contaminating the dropper tip or the solution.
- Tilt your head back: Gently pull down your lower eyelid to create a small pocket.
- Position the dropper: Hold the dropper with the tip facing down, as close to your eye as possible without touching it.
- Instill the drop: Look up and away from the dropper and gently squeeze to release a single drop into the eyelid pocket.
- Close your eyes gently: Close your eyes for 2 to 3 minutes without blinking or squinting.
- Use finger pressure: For about a minute, gently press your finger to the inner corner of your eye near the nose. This prevents the liquid from draining into your tear duct, increasing absorption.
- Wait between drops: If using other eye drops, wait at least 5 minutes before administering the next medication.
ACULAR vs. Other Eye Drops
Understanding the differences between ACULAR and other types of eye drops is important, particularly for treating allergies.
| Feature | ACULAR (Ketorolac) | Epinastine (Elestat) / Alcaftadine (Lastacaft) | Ophthalmic Steroids | Ophthalmic Antibiotics |
|---|---|---|---|---|
| Drug Class | Nonsteroidal Anti-inflammatory Drug (NSAID) | Antihistamine and Mast Cell Stabilizer | Corticosteroid | Antibiotic |
| Mechanism of Action | Blocks prostaglandins to reduce inflammation and pain. | Blocks histamine and prevents mast cell degranulation, stopping the allergic response. | Suppresses the immune response, reducing inflammation. | Kills or inhibits the growth of bacteria. |
| Primary Use | Post-op pain/inflammation; allergic conjunctivitis. | Allergy-related eye itching and redness. | Severe inflammation, often short-term. | Bacterial eye infections. |
| Availability | Prescription only. | Varies (Lastacaft OTC; Epinastine Rx). | Prescription only. | Prescription only. |
| Frequency | 2 to 4 times per day. | Epinastine (2x daily); Lastacaft (1x daily). | Varies by strength and condition. | Varies by infection. |
Potential Side Effects and Precautions
While ACULAR is a valuable treatment, it's important to be aware of its potential side effects and necessary precautions.
Common Side Effects
- Temporary stinging or burning upon instillation
- Blurred vision
- Eye redness
- Headaches
More Serious Risks
Rarely, prolonged use or certain patient factors can lead to more severe issues, including:
- Corneal complications (e.g., thinning, perforation)
- Delayed wound healing, especially when used alongside topical steroids
- Increased risk of bleeding in ocular tissues, particularly during eye surgery
Precautions and Contraindications
- Contact Lenses: Soft contact lenses should be removed before use and reinserted at least 15 minutes after application.
- Bleeding Disorders: ACULAR should be used with caution in patients with a history of bleeding problems.
- Underlying Conditions: Patients with diabetes, rheumatoid arthritis, or dry eye syndrome may be at higher risk for corneal complications.
- Pregnancy: It is not recommended during the last trimester of pregnancy.
- Allergies: Those with known sensitivities to aspirin or other NSAIDs may be at risk for allergic reactions.
For more information on the medication, including its safety and use, you can consult sources like the MedlinePlus Drug Information.
Conclusion: The Role of ACULAR in Eye Health
In summary, the purpose of ACULAR eye drops is to provide powerful anti-inflammatory and pain-relieving effects directly to the eye. As a topical NSAID, it plays a vital role in post-surgical recovery, particularly following cataract or corneal procedures, by mitigating inflammation and reducing discomfort. Furthermore, it offers effective relief from the bothersome itching associated with seasonal allergic conjunctivitis. Its targeted action provides significant relief for patients, helping to improve healing and overall eye comfort, though it must be used strictly as prescribed and with proper precautions.
