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11. Eye

First line drugs Second line drugs Specialist drugs Secondary care drugs
Recommended in both primary and secondary care Alternatives (often in specific conditions) in both primary and secondary care; Where a specialist input is needed (see introduction for definition) Prescribing principally within secondary care only

Traffic light status explained:

  • Green: Routine prescribing within licensed indication
  • Amber 1: specialist recommendation followed by GP initiation and continuation
  • Amber 2: specialist or GP initiation in line with local guideline after 1st line failure followed by GP continuation
  • Amber 3: specialist initiation and stabilisation followed by GP continuation
  • Amber SCG: specialist initiation and stabilisation followed by GP continuation in line with an agreed shared care guideline
  • Red: Hospital or specialist prescribing only
  • Double Red: These medicines have been evaluated and rejected by MKPAG and are NOT approved for use within MK. They are not recommended for use because of lack of clinical effectiveness, cost effectiveness or safety.

 

 

 

Patient information on how to use your eye drops

Follow this link for patient information on how to use your eye drops using the wrist-knuckle technique: https://www.moorfields.nhs.uk/sites/default/files/How%20to%20use%20your%20eye%20drops_0.pdf

When two or more different eye-drop preparations are used at the same time of day, or ointment at the same time as drops, the patient should leave an interval of 5 minutes between preparations to avoid dilution and overflow.

 

 

Contents

 

1. Allergic and inflammatory eye conditions

  • Allergic conjunctivitis
  • Inflammatory eye conditions
  • Anterior uveitis

 

2. Dry eye conditions

 

3. Eye infections

  • Bacterial eye infection
  • Viral eye infection
  • Ophthalmic herpes simplex

 

4. Eye procedures

  • Post-operative pain and inflammation

 

5. Glaucoma and ocular hypertension

 

6. Retinal disorders

  • Macular degeneration
  • Macular oedema
  • Optic neuropathy
  • Vitreomacular traction

 

 

Administration aids

Eye drop dispensers are available to aid the instillation of eye drops especially amongst the elderly, visually impaired, arthritic, or otherwise physically limited patients; they may be useful in children in whom normal application is difficult.

 

Follow this link (Know Your Drops) for further information on administration aids: https://www.moorfields.nhs.uk/knowyourdrops

 

Eye drop dispensers are for use with plastic eye drop bottles, for repeated use by individual patients. 

 

 

Preservatives and sensitisers

  1. Long-term administration of preservative containing eye drops may cause ocular irritation.
  2. Some patients using preservative-free eye drops in multiple-use containers could be at risk of serious eye infection due to microbial contamination of the product. Doctors should exercise caution when prescribing multiple-use eye drops without preservative in patients at high risk of infection.
  3. All Minims and other single use products are preservative free.
  4. Initiation of preservative-free eye drops will be by HOSPITAL CONSULTANT INITIATION ONLY. They should only be used if the patient is known to be allergic to benzalkonium chloride or is at increased risk of developing sensitivity.

 

 

Contact len users

  • Contact lens solutions are not allowed on FP10.
  • Acanthamoeba keratitis, a sight-threatening condition, is associated with ineffective lens cleaning and disinfection or the use of contaminated lens cases. The condition is especially associated with the use of soft lenses.
  • Special care is required in prescribing eye preparations for contact lens users.
  • Some drugs and preservatives in eye preparations can accumulate in hydrogel lenses and may induce toxic reactions. Therefore, unless medically indicated, the lenses should be removed before instillation and not worn during the period of treatment.
  • Ointment preparations and oily eye drops should be used following specialist advice in conjunction with contact lens wear.
  • Many drugs given systemically can also have adverse effects on contact lens wear – refer to BNF for details. 

 

Last updated by: Dupe Fagbenro on 06-11-2018 15:31