Guideline Profile : Dry eyes

The Surrey Heartlands Integrated Care System Area Prescribing Committee have agreed updated Dry eye guidelines and associated resources following the discontinuation of Evolve Preservative Free Hypromellose 0.3%.

This preparation has been replaced by AddTear® Hypromellose  0.3% PF 10ml & Ocufresh®  Hypromellose  0.3% PF 10ml

The local Dry Eye Guidance has been updated (see Guidance document for full details). 
Eye drops for dry eye should be prescribed by BRAND.
Brand prices vary, so local recommendations for cost-effective options have been made (see documents for Mild/Moderate and Severe dry eye Preferred treatment options).
OptimiseRx messages (Primary Care only) will be utilised to recommend the preferred treatment options.

Key points:
Self-care is recommended for patients requiring occasional and intermittent treatment. There are numerous ocular lubricants available to purchase from pharmacies.

Switching from non-preferred products to preferred brands has been agreed by the APC and the specialist ophthalmology teams except for: 

• Corneal patients with a history of transplants
• very severe dry eyes (diagnosed in secondary care) where the patient has developed corneal staining and filamentary keratitis or recurrent infections
• Neurotrophic keratopathy
• non-healing epithelial defects

Unit dose vials should be switched to 10ml preservative-free bottles where appropriate - see guidance for further details.

Patient resources, including an eye-drop administration guide video, information leaflets and a guide to compliance aids can be obtained through the Moorfields "Know your drops" website: https://www.moorfields.nhs.uk/knowyourdrops