Douglas J. Rhee, MD

70A. AGENTS USED IN NEURO-OPHTHALMOLOGYDrug Trade Preparation Usual Dose Notesbotulinum toxin Botox Injection Varies depending on the Used in treatment of blepharospasm ,entity being treated strabismus, and hemifacial spasmcocaine N/A Soln, 10% 1 drop, repeat in 1 minute Used in diagnosis of Horner’s syndrome 1edrophonium chloride Tensilon IV Soln, 10 mg/ml 2–3 mg IV (0.2–0.3 cc) 2 Used in diagnosis of myasthenia gravis ; 1 ifunresponsive and no side effects seenafter 1 min., may give 0.4 cc Q30 sec × 2hydroxyamphetamine Paredrine Soln, 1% 1 drop, repeat in 1 minute Used in diagnosis of Horner’s syndrome 1No longer available in USmethylprednisolone Solu-Medrol IV Soln 250 mg IV Q6 hr Treatment of optic neuritis and giant cellarteritis (see below for further discussion)Special (See Below) Traumatic optic neuropathypilocarpine N/A Soln, 0.125% 1 drop Lower strength used in diagnosis andtreatment of Adie’s pupil 11 For protocol, refer to Rhee DJ, Pyfer, MF, eds. The Wills Eye Manual: Offi ce and Emergency Room Diagnosis and Treatment of Eye Diseases, 3rd ed.Philadelphia: Lippincott Williams & Wilkins, 1999.2 Potential for causing cholinergic crisis, treatment of which includes IV atropine.