North of Tyne, Gateshead and North Cumbria
Area Prescribing Committee Formulary
 
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11 Eye

NORTH OF TYNE AND GATESHEAD GUIDELINES FOR MANAGEMENT OF COMMON OPHTHALMOLOGIAL CONDITIONS IN PRIMARY / COMMUNITY CARE

Preservative Free Eye Drops
Microbial contamination of multidose bottles of eye drops can cause eye infections that may lead to damage of the eye and in extreme cases loss of sight. To minimise the risk, multidose bottles of eye drops contain an antimicrobial preservative such as benzalkonium chloride. The preservatives used in eye drops are normally well tolerated, but they are not completely harmless. They can cause irritation and damage to the corneal epithelium. This risk is understood to be greater in patients with pre-existing damage to the ocular surface and where large quantities of preservative containing eye drops are applied repeatedly over a prolonged period (e.g. if applied more than 4 to 6 times daily for several weeks/ months).
To avoid these problems the use of preservative-free eye drops is recommended in:
 Patients who have experienced hypersensitivity reactions or irritation due to preservatives in eye drops.
 Patients who have received corneal grafts.
 Patients with conditions where there is already damage to the ocular surface as a result of disease or trauma, such as dry eye, blepharitis, ocular burns etc.
Treatment with preservative-free eye drops will usually be initiated by an ophthalmologist and details on their availability and use is available from the pharmacy at Newcastle’s Royal Victoria Infirmary (and on the North of Tyne and Gateshead Area Prescribing Committee’s website).

11-08-02-04 Other

Ascorbic acid 10% Preservative-free eye drops
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Disodium edetate 0.37% solution
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Sodium Citrate 10.11% eye drops
Formulary

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Tretinoin 0.05% eye drops
Formulary

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