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 Formulary Chapter 11: Eye - Full Chapter
Notes:

Calculating Quantities of Eye Drops:

[The following is a guide and will depend on issues such as dexterity and accuracy which should be assessed at point of prescribing.]

It is generally accepted that 5ml = 100 drops & 10ml = 200 drops etc. (Ranges can vary and can be 100-130 for 5 ml when allowing for overage) 

General Advice:

  • The eye typically holds 1 drop. Instruction such as 1-2 drops can be interpreted as wasteful as the second drop washes out the first. Should multiple drops be required or multiple products it is advised that the individual waits 5-10mins between drops to allow the first to work.
  • Where possible specify which eye the drops are to be used in. This helps patients compliance and adherence, but also helps when transferring information between services and care settings.
  • If eye ointment is being used along with a drop then patients should be advised to use drops first and then 5-10 minutes later apply ointment. Most ointments will temporarily blur vision and care should be taken during this time.
  • Check if the patient wears contact lenses. The majority of eye preparations require lenses to be removed whilst using them.
  • Administration aids are available should dexterity/ accuracy be an issue.
  • Some preparations may cause stinging/irritation on application, this should ease quickly. However should patients find this is not manageable, is not improving, or getting worse then a review will be needed to find a more suitable option
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 Details...
11.08.02  Expand sub section  Ocular diagnostic and peri-operative preparations and photodynamic treatment
11.08.02  Expand sub section  Ocular diagnostic preparations
11.08.02  Expand sub section  Ocular peri-operative drugs
Acetylcholine Chloride (Miochol-E®)
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Green Hospital
 
   
Apraclonidine (Iopidine®)
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Red
 
   
Diclofenac (Voltarol® Ophtha)
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Red
 
   
Ketorolac (Acular®)
(Eye)
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Red
 
   
11.08.02  Expand sub section  Subfoveal choroidal neovascularisation
11.08.02  Expand sub section  Vitreomacular traction to top
 ....
Key
note Notes
Section Title Section Title (top level)
Section Title Section Title (sub level)
First Choice Item First Choice item
Non Formulary Item Non Formulary section
Restricted Drug
Restricted Drug
Unlicensed Drug
Unlicensed
Track Changes
Display tracking information
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
SMC
Scottish Medicines Consortium
Cytotoxic Drug
Cytotoxic Drug
CD
Controlled Drug
High Cost Medicine
High Cost Medicine
Cancer Drugs Fund
Cancer Drugs Fund
NHSE
NHS England
Homecare
Homecare
CCG
CCG

Traffic Light Status Information

Status Description

Green

Drugs that may be initiated, stabilised and maintained by primary, secondary or tertiary care Secondary and tertiary care prescribing may be continued by primary care. [this does not indicate first/second line choice]  

Green Hospital

Items used by the Hospital but would not normally be continued into primary care. Primary care prescribers can change to GREEN first or second.   

Green plus

Initiation of drugs by primary care following written advice from secondary/ tertiary care advice. These can then be continued by primary care with little or no monitoring requirements.  

Yellow

Drugs that may be continued in primary care following initiation and stabilisation in secondary/tertiary care  

Advice

Drugs which require initiation by secondary or tertiary care. These should be continued until patient stabilised. Once stable an agreement with the GP should be met to take over prescribing and any monitoring between specialist reviews. The specialist will provide prescribing guidelines for the management of these patients.  

Amber

Items requiring a shared care agreement. These items should be initiated and stabilised by secondary or tertiary care. The GP should only be asked to take over prescribing through a formal shared care agreement. Secondary care will be expected to continue prescribing until the agreement is made.  

Red

Hospital/ Trust ONLY. These are items the secondary and tertiary care are responsible for prescribing and will need to continue to prescribe for long term maintenance. These items will NOT be prescribed in primary care. But primary care should be informed the patient is receiving these items. This will include NHSE funded items requiring repatriation.  

GP - Black

Items covered by NHSE ‘Should not prescribe in primary care list’ – See CCG policy on Drugs of limited clinical value  

GP - Grey

Grey List: Items covered by NHSE ‘Should not prescribe in primary care list’ that are not to be routinely prescribed but may be suitable in a defined population – See CCG policy on Drugs of limited clinical value  

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