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Although most medications for ophthalmic disease are administered locally, systemic absorption occurs as the drug passes into the nasopharynx by way of the nasolacrimal duct and may lead to a significant systemic exposure. Knowledge of the mechanism of action of the drug, extent of systemic exposure, and its corresponding risks are important factors that must be considered before prescription of any ophthalmic agent. The relative risk in turn depends on the agent prescribed, plasma levels achieved, and individual susceptibility factors. Judicious use of pharmacotherapy in the management of ophthalmic disease should minimize the risk-benefit ratio.
Dr. P.J. Lama, Division of Glaucoma, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, 90 Bergen Street, Newark, NJ 07103, USA
11.1 General management, indication (Part of: 11 Medical treatment)