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 |

[pic] [pic] [pic]

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® |

[pic]

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) |

[pic] [pic] [pic]

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%) |

[pic] [pic] [pic]

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 |

[pic] [pic] [pic] [pic]

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.

[pic] [pic]

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:

 [pic]

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®

[pic]

Sodium Hyaluronate 0.4%(single dose preservative free) - CLINITAS ®     

[pic]

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.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download