OCULAR LUBRICANTS FLOWCHART
OCULAR LUBRICANTS FLOWCHART
Mild dry eyes (Grade 1)
Hypromellose 0.5% or Carbomer QDS + ointment (e.g. Lacri-Lube®) at night:
|Hypromellose 0.5% |
|Carbomer 980 0.2% e.g. Viscotears |
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Preservative free (if patient intolerant to preservatives / unsuitable for preservatives e.g. already on frequent preserved eye drops for co-existing ocular conditions)
|Polyvinyl alcohol e.g. Refresh Ophthalmic® |
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Moderate dry eyes (Grade 2)
Preservative free preparation (6≥) + ointment (e.g. Lacri-Lube®) at night:
Multidose bottle - preservative free
|Sodium hyaluronate (e.g. Hyabak® 0.15%; Hylo-Forte® 0.2%+ ComplEye aid) |
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Single dose units – preservative free
|Polyvinyl alcohol e.g. Refresh Ophthalmic® |
|Hydroxypropyl-guar (e.g. Systane®) |
|Carmellose (e.g. Celluvisc® 1% or if not tolerated 0.5%) |
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Severe dry eyes (Grades 3 or 4)
Refer to Cornea and External Eye Disease Clinic
Patients may need the following in addition to / instead of any of the above-mentioned lubricants:
|Sodium hyaluronate (e.g. Vismed® 0.18%, Clinitas® 0.4%) |
|Acetylcysteine 5% - 10% preserved and preservative free RESTRICTED to CORNEAL CONSULTANTS |
|only (SPECIALS) |
|Anti-inflammatory agents e.g. Ketorolac |
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Created by: Anar Meghji, Dispensary Pharmacist; Ratified by : Lucy Titcomb, Directorate Pharmacist
IMPORTANT
Please remember to prescribe HYLO-FORTE® with a ComplEye aid. When Hylo-Forte® is used with a ComplEye aid - we recommend a 6 month expiry, without a ComplEye aid we reduce the expiry to 28 days as there is more potential for contamination.
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Please remember you can also prescribe the following sodium hyaluronate products in accordance with the lubricant guidelines (attached) – on the ward, in casualty and in clinic:
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Sodium Hyaluronate 0.15%( multidose preservative free) – HYABAK®- 8 week expiry on opening(NOT advisable for inpatient prescribing) [Both Hylo-Forte® and Hyabak® are NOT advisable for inpatient prescribing as the in use shelf-life for these products would be only 14 days on the inpatient ward(as for all eye drops used on the wards). ]
Sodium Hyaluronate 0.18% (single dose preservative free) – VISMED®
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Sodium Hyaluronate 0.4%(single dose preservative free) - CLINITAS ®
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Please note that Hylo-Care®, Hylo-Tear®, Oxyal®, Vismed Multi®, Optive®, Systane Ultra® are NON FORMULARY and must NOT be prescribed, on FP10 or otherwise.
Should you have any further queries, do not hesitate to contact us on ext 6717 / 6716.
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