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11.2 Dry Eye conditions

First line drugs Second line drugs Specialist drugs Secondary care drugs

Traffic light status (TLS) 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.

 

 

11.2 Dry Eye Conditions

 

Dry Eye

Patients should be encouraged to manage both dry eyes and sore eyes by implementing some self-care measures such as good eyelid hygiene and avoidance of environmental factors alongside treatment

Mild to moderate cases of dry eye syndrome or sore tired eyes can usually be treated using lubricant eye treatments that consist of a range of drops, gels and ointments that can be easily be purchased over the counter.

 

 

Local guideline:

"Prescribing Guideline for Dry Eye Syndrome" (Oct 2018) 

 

 

Ocular lubricants

 

Hypromellose

  • Eye drops 0.3%
  • Evolve® Hypromellose (preservative-free)

Notes:

  • Should not be prescribed in Primary Care or at Discharge
  • Advise patient to purchase, unless prescription is for long-term regular use

 

Carbomer 980

  •  Clinitas Carbomer gel 0.2%

Note:

  • Suitable for contact lens wearers

 

 

Carmellose Sodium 0.5%

  • Optive eye drops (Carmellose sodium 0.5%, glycerol 0.9%)
  • Optive Fusion eye drops (sodium hyaluronate 0.1%, carmellose sodium 0.5%, glycerol 0.9%)

Notes:

  • Contains preserving system which biodegrades on contact with the eye.
  • 6 month expiry once open.
  • Suitable for contact lens wearers.

 

 

Carmellose Sodium 1%

  • Celluvisc 1% preservative-free single use eye drops

Note:

  • Suitable for contact lens wearers.

 

 

Carmellose Sodium 0.5% (Amber 2)

  • Optive Plus eye drops (Carmellose sodium 0.5%, glycerol 1%, castor oil 0.25%)

Notes:

  • For use in evaporative dry eyes (for hospital specialist initiation)

 

 

Liquid Paraffin

  • VitA-POS® eye-ointment contains Retinol palmitate 250iu/g, liquid paraffin, wool fat

Notes:

  • Can be used at any stage of dry eye treatment
  • not suitable with contact lenses.
  • Best suited for application before sleep.

 

 

Acetylcysteine (Amber 2)

  • Ilube® 5% eye drops
  • 10% eye drops (preservative-free bottle); Unlicensed, Pending supplier

Notes:

  • For hospital specialist initiation in dry eye conditions assoiciated with mucus production

 

 

Sodium Hyaluronate (Amber 2)

  • Hylo-Tear® preservative-free eye drops 0.1%
  • Hylo-Forte® preservative-free eye drops 0.2%

Note:

  • 6 month expiry once open.
  • Suitable for contact lens wearers.

 

 

Sodium Hyaluronate (Amber 2)

  • Clinitas® preservative-free eye drops 0.4%; reclosable single dose units and may be used for up to 12 hours

Notes:

  • For Sjogrens dry eye (for consultant initiation only)

 

 

Systane (Amber 2)

  • Propylene glycol 0.3%, polyethylene glycol 400 0.4% 
  • Preservative-free single use eye drops 

Note:

  • For artificial eyes

 

 

Sodium Chloride 0.9% (Amber 2)

  • Minims® Single use eye drops
  • Balances Salt Solution (BSS) Eye irrigation solutions (not prescribable in primary care)

Notes:

  • Irritation, including first-aid removal of harmful substances

 

 

Ciclosporin (Amber 3)

  • Ikervis® 0.1% single use eye drops (30x0.3ml)

 

Notes:

  • Only to be initiated by external diseases / corneal clinicians as per NICE TA 369

 

 

 

Paraffin, Yellow, Soft

  • Simple Eye ointment  

 

 

 

 

 

Traffic light status (TLS) 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.
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Return to Chapter: 11. Eye

Last updated by: Dupe Fagbenro on 01-02-2019 14:15