Eye Drops Guide

Comprehensive guide to common ophthalmic medications including cap colors, dosing schedules, and taper protocols

Understanding Cap Colors

Eye drop bottles use color-coded caps to help identify medication types and prevent mix-ups. While colors are generally standardized, always verify the medication name before using.

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Latanoprost (Xalatan)

Glaucoma - Prostaglandin Analog

Teal/Turquoise
Dosing:

Once daily at bedtime

Common Uses:
Primary open-angle glaucomaOcular hypertension
Side Effects:
  • Iris darkening
  • Eyelash growth
  • Redness
  • Orbital fat atrophy

Note: Most effective glaucoma medication. Store unopened bottles in refrigerator. Once opened, can be kept at room temperature for 6 weeks.

Timolol (Timoptic)

Glaucoma - Beta Blocker

Yellow
Dosing:

Twice daily (morning and evening)

Common Uses:
GlaucomaOcular hypertension
Side Effects:
  • Can worsen asthma/COPD
  • Bradycardia
  • Fatigue

Note: Contraindicated in asthma and heart block. Absorbed systemically - occlude puncta after instilling.

Brimonidine (Alphagan)

Glaucoma - Alpha Agonist

Purple
Dosing:

2-3 times daily

Common Uses:
GlaucomaOcular hypertension
Side Effects:
  • Redness/allergy common
  • Dry mouth
  • Fatigue

Note: Many patients develop allergy over time. Avoid in children under 2.

Dorzolamide (Trusopt)

Glaucoma - Carbonic Anhydrase Inhibitor

Orange
Dosing:

2-3 times daily

Common Uses:
GlaucomaOcular hypertension
Side Effects:
  • Bitter taste
  • Stinging
  • Superficial punctate keratitis

Note: Contraindicated in sulfa allergy. Less effective than prostaglandins.

Prednisolone Acetate 1% (Pred Forte)

Steroid - Post-Surgical

Pink
Dosing:

Varies - typically QID initially

Taper Schedule:

Common post-op taper: QID × 1 week, TID × 1 week, BID × 1 week, QD × 1 week, then stop

Common Uses:
Post-cataract surgeryUveitisInflammation
Side Effects:
  • Elevated IOP
  • Cataract formation with prolonged use
  • Delayed wound healing

Note: SHAKE WELL before use. Must taper gradually. Monitor IOP regularly.

Moxifloxacin (Vigamox)

Antibiotic

Tan/Beige
Dosing:

TID for infection; varies post-operatively

Common Uses:
Bacterial conjunctivitisPost-operative prophylaxis

Note: 4th generation fluoroquinolone. Excellent gram positive and gram negative coverage.

Gatifloxacin (Zymaxid)

Antibiotic

Tan/Brown
Dosing:

BID-TID for 7 days

Common Uses:
Bacterial conjunctivitisPost-operative prophylaxis

Note: 4th generation fluoroquinolone. Similar to moxifloxacin.

Ketorolac (Acular)

NSAID

Gray/White
Dosing:

QID, often started 1 day before surgery

Common Uses:
Post-operative inflammationCystoid macular edema preventionOcular pain
Side Effects:
  • Stinging
  • Superficial punctate keratitis
  • Delayed wound healing

Note: Often used in combination with steroids post-operatively.

Bromfenac (Prolensa)

NSAID

Clear/Gray
Dosing:

Once daily

Common Uses:
Post-operative inflammationMacular edema prevention

Note: Once-daily dosing improves compliance over ketorolac.

Cyclopentolate (Cyclogyl)

Cycloplegic/Dilating Drop

Red
Dosing:

Typically 1-2 drops for dilation

Common Uses:
Cycloplegic refraction in childrenUveitisPupil dilation

Note: Effects last 6-24 hours. Causes blurred near vision.

Atropine 1%

Cycloplegic - Long-Acting

Red/Pink
Dosing:

Once daily to TID depending on indication

Common Uses:
UveitisCycloplegic refractionAmblyopia treatment (low dose)

Note: Very long-acting (7-14 days). Low-dose (0.01%) used for myopia control in children.

Artificial Tears (various brands)

Lubricant

Various (often blue or clear)
Dosing:

As needed, up to every hour if needed

Common Uses:
Dry eyeOcular surface irritation

Note: Preservative-free preferred for frequent use. Many formulations available (gels, ointments, drops).

Restasis (cyclosporine 0.05%)

Immunomodulator - Dry Eye

White
Dosing:

Twice daily

Common Uses:
Chronic dry eye

Note: Takes 3-6 months for full effect. Increases natural tear production.

Xiidra (lifitegrast)

Immunomodulator - Dry Eye

Purple
Dosing:

Twice daily

Common Uses:
Dry eye
Side Effects:
  • Dysgeusia (bad taste)
  • Instillation site irritation

Note: Works faster than Restasis (weeks vs months).

Cequa (cyclosporine 0.09%)

Immunomodulator - Dry Eye

White
Dosing:

Twice daily

Common Uses:
Dry eye

Note: Higher concentration than Restasis with nanomicellar technology for better penetration.

Lotemax (loteprednol)

Steroid - Ester-Based

Pink/White
Dosing:

QID initially, then taper

Common Uses:
Post-operative inflammationAllergic conjunctivitisUveitis

Note: Lower risk of IOP elevation compared to prednisolone. Less potent.

Azithromycin (AzaSite)

Antibiotic

White
Dosing:

BID × 2 days, then QD × 5 days

Common Uses:
Bacterial conjunctivitisBlepharitis

Note: Macrolide antibiotic. Good for blepharitis due to anti-inflammatory properties.

Erythromycin Ointment

Antibiotic Ointment

N/A (ointment tube)
Dosing:

Small ribbon to lower lid 2-4 times daily

Common Uses:
Bacterial conjunctivitisProphylaxis in newbornsNighttime lubrication

Note: Safe in children. Causes temporary blur - use at bedtime.

Dexamethasone 0.1%

Steroid

White/Clear
Dosing:

QID initially

Taper Schedule:

Must taper gradually depending on indication

Common Uses:
InflammationUveitisPost-surgical

Note: More potent than loteprednol, less than prednisolone acetate.

Combigan (brimonidine/timolol)

Glaucoma - Combination

Purple/Yellow combination indicator
Dosing:

Twice daily

Common Uses:
GlaucomaOcular hypertension

Note: Combination drop - more convenient than using two separate medications.

Cosopt (dorzolamide/timolol)

Glaucoma - Combination

Orange/Yellow combination
Dosing:

Twice daily

Common Uses:
GlaucomaOcular hypertension

Note: Combination drop reduces number of medications needed.

Important Reminders

  • •Wait 5 minutes between different eye drops to prevent washout
  • •Ointments go in LAST after all drops
  • •Don't stop steroids abruptly - always taper as directed
  • •Close eyes gently after drops - don't squeeze tight
  • •Occlude puncta (press inner corner of eye) for 1-2 minutes after drops to reduce systemic absorption
  • •Check expiration dates - discard drops 4-6 weeks after opening unless preservative-free
  • •Never share eye drops between people
  • •Don't touch dropper tip to eye or any surface