BNF for Children 2011-2012

530 11.8.1 Tear deficiency, ocular lubricants, and astringents BNFC 2011–201211 Eye(e.g. hourly) for adequate relief. Ocular surface mucin isoften abnormal in tear deficiency and the combinationof hypromellose with a mucolytic such as acetylcysteinecan be helpful.The ability of carbomers to cling to the eye surface mayhelp reduce frequency of application to 4 times daily.Polyvinyl alcohol increases the persistence of the tearfilm and is useful when the ocular surface mucin isreduced.Sodium hyaluronate eye drops are also used in themanagement of tear deficiency.Sodium chloride 0.9% drops are sometimes useful intear deficiency, and can be used as ‘comfort drops’ bycontact lens wearers, and to facilitate lens removal.Special presentations of sodium chloride 0.9% andother irrigation solutions are used routinely for intraocularsurgery and in first-aid for removal of harmfulsubstances.Eye ointments containing a paraffin can be used tolubricate the eye surface, especially in cases of recurrentcorneal epithelial erosion. They may cause temporaryvisual disturbance and are best suited for applicationbefore sleep. Ointments should not be used duringcontact lens wear.ACETYLCYSTEINEIndication and doseTear deficiency, impaired or abnormal mucusproductionApply 3–4 times dailyIlube c (Moorfields) AEye drops, acetylcysteine 5%, hypromellose 0.35%.Net price 10 mL = £10.09Excipients include benzalkonium chloride, disodium edetateCARBOMERS(Polyacrylic acid)Synthetic high molecular weight polymers of acrylic acid crosslinkedwith either allyl ethers of sucrose or allyl ethers ofpentaerithritylLicensed use some preparations not licensed for usein childrenIndication and doseDry eyes including keratoconjunctivitis sicca,unstable tear filmApply 3–4 times daily or as requiredGelTears c (Bausch & Lomb)Gel (= eye drops), carbomer 980 (polyacrylic acid)0.2%, net price 10 g = £2.80Excipients include benzalkonium chlorideLiposic c (Bausch & Lomb)Gel (= eye drops), carbomer 980 (polyacrylic acid)0.2%, net price 10 g = £2.96Excipients include cetrimideLumecare c Long Lasting Tear Gel (Medicom)Gel (= eye drops), carbomer 980 (polyacrylic acid)0.2%, net price 10 g = £2.10Excipients include cetrimideViscotears c (Novartis)Liquid gel (= eye drops), carbomer 980 (polyacrylicacid) 0.2%, net price 10 g = £2.94Excipients include cetrimideLiquid gel (= eye drops), carbomer 980 (polyacrylicacid) 0.2%, net price 30 0.6-mL single-dose units =£5.42CARMELLOSE SODIUMIndication and doseDry eye conditionsApply as requiredOptive c (Allergan)Eye drops, carmellose sodium 0.5%, glycerol, netprice 10 mL = £7.49Single useCarmellose (Non-proprietary)Eye drops, carmellose sodium 0.5%, net price 30 0.4 mL = £5.75Note Each unit is resealable for up to 12 hoursCarmize c (Aspire)Eye drops, carmellose sodium 0.5%, net price 30 0.4 mL = £5.75, 90 0.4 mL = £15.53; 1%, 30 0.4 mL = £3.00, 60 0.4 mL = £6.00Celluvisc c (Allergan)Eye drops, carmellose sodium 0.5%, net price 30 0.4 mL = £5.75, 90 0.4 mL = £15.53; 1%, 30 0.4 mL = £3.00, 60 0.4 mL = £10.99HYDROXYETHYLCELLULOSEIndication and doseTear deficiencyApply as requiredMinims c Artificial Tears (Bausch & Lomb)Eye drops, hydroxyethylcellulose 0.44%, sodiumchloride 0.35%. Net price 20 0.5 mL = £8.21HYDROXYPROPYL GUARIndication and doseDry eye conditionsApply as requiredSystane c (Alcon)Eye drops, hydroxypropyl guar, net price 10 mL =£4.66Single useSystane c (Alcon)Eye drops, hydroxypropyl guar, net price 28 0.8 mL= £4.66HYPROMELLOSEIndication and doseTear deficiencyApply as requiredNote The Royal Pharmaceutical Society has stated thatwhere it is not possible to ascertain the strength ofhypromellose prescribed, the prescriber should be contactedto clarify the strength intended.Hypromellose (Non-proprietary)Eye drops, hypromellose 0.3%, net price 10 mL =£1.61Excipients may include benzalkonium chlorideBrands include Lumecare c Hypromellose