Formulary

11.1 Administration of drugs to the eye

First Line
Second Line
Specialist
Hospital Only

Eye Drops

Pull down the lower lid to form a 'pocket'. Squeeze one drop into this pocket. Provided this is successfully achieved one drop is sufficient. Apply pressure to the inner corner of the eye for 1 minute to reduce drainage of the drop through the tear duct.

If different drops are to be given at the same time of day there should be an interval of about 3 minutes between treatments. Preparations that sting should be given last.

Systemic absorption via the nasal mucosa may be a problem with some drugs, e.g. beta blockers or adrenaline, and this can be minimised by compressing the lacrimal sac at the medial canthus for 1minute during and after administration.

Ointment

Pull down the lower lid and squeeze about 1cm of ointment into the centre of the lower lid. If drops and ointment are used at the same time, drops should be given first.

Devices

A variety of devices are available to assist patients with the self-administration of drops.

The Opticare device (£4.92) may be prescribed on FP10 and fits the majority of bottles. Notable exceptions being Timoptol LA for which an aid is available from MSD, and Xalatan for which community pharmacists may obtain a device from Pfizer (01737 330000). It can accommodate Travatan and Duotrav but a special device is available from Alcon (08000 924567) free of charge. To use Opticare with the MSD products Trusopt, Cosopt, and Timoptol the bottle must be inserted flat side first with the lid removed.

Opticare Arthro 5 (for 2.5mL and 5mL bottles) and Opticare Arthro 10 (for 2.5mL, 5mL, 10mL, 15mL and 20mL bottles) may also prescribed on FP10 (£4.92).

Compatibilities with these products can be checked with the manufacturer on 01484 667822 or at the Cameron-Graham website

Preservative free eye drops

Preservative intolerance should only be diagnosed by an ophthalmologist.

Branded preservative free drops (e.g. Minims®) should be prescribed when available as manufactured 'specials' cost significantly more and do not have a product license.