Summary study book BNF 78 (British National Formulary) September 2019 of Joint Formulary Committee (Chapter 11 - Eye) - ISBN: 9780857113511, Edition: 78, Year of publication: - (Summary of the EYE)
CONTACT LENSES
Chapter 11 – Eye
With extended wear = risk of keratitis
Acanthamoeba keratitis – painful, sight
EYE DROPS AND OINTMENTS threatening condition is linked with
Drops – instilled into the pocket formed by ineffective lens cleaning, etc
gently pulling down lower eyelids and keeping Drugs/preservatives may accumulate in
eye closed for as long as possible lenses = toxic and adverse reactions hence
remove lenses before instilling prep and
If 2 different drops are used at same time – during period of Tx
leave interval of at least 5 mins to prevent Unpreserved drops may be used
dilution and overflow. Extend interval when AVOID ointments preps and oily eye drops
gels/suspensions are used
Apply ointment after drops Drugs given systemically may also have an
To prevent nasolacrimal drainage and effect on contact lens wear:
reduce systemic absorption – press on the - Oral contraceptives (high ER content)
lacrimal punctum for at least a minute - Drugs which reduce blink rate (anxiolytics,
hypnotics, antihistamines, muscle relaxants)
Eye lotions (sterile NaCl 0.9% solution) - flush - Drugs which reduce lacrimation (AHs,
out irritants or foreign bodies as a 1st aid Tx
antimuscarinics, phenothiazines, beta
Eye drops which can be prepared aseptically = blockers, diuretics, TCAs)
amphotericin, ceftazidime, cefuroxime, - Drugs which increase lacrimation
colistimethate, desferrioxamine, (ephedrine, hydralazine)
dexamethasone, gentamicin, vancomycin - Conjunctival inflammation (isotretinoin)
- Irritation (aspirin)
CONTROL OF MICROBIAL - Rifampicin, sulfasalazine (discolour lenses)
CONTAMINATION
ALLERGIC AND INFLAMMATORY
Drops in multi-application containers for
CONDITIONS
domiciliary use must not be used for > 4 weeks
after first opening (unless otherwise) Corticosteroids
Topical – applied frequently for the first 24-
Multi-application drops used in hospital wards
48 hours; reduce frequency when
are discarded 1 week after first opening
inflammation is controlled
In outpatient departments, use single- Intravitreal implant (dexamethasone or
application containers. If multi-app containers fluocinolone)
are used, discard after use within 1 session
Risks associated with use:
In eye surgery, use single-app containers 1. ‘Red eye’ – due to herpes simplex virus may
be aggravated by CS = corneal ulceration,
Containers used before an eye op should be
damage to vision and loss of eye
discarded at the time of op and fresh
2. ‘Steroid glaucoma’
containers should be given post-op
3. ‘Steroid cataract’ – with prolonged use
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