Dispensing Optics - ABDO

More documents

Recommendations

Info

6 dispensingoptics July 2009 Figure 5: Hyaluronic acid used as a lip plumper for severe dry eye or at night, and are not suitable for contact lens wearers. Hydroxypropyl guar (HP-Guar) HP-Guar, found in Systane, claims to bind to the damaged ocular surface, Dry eye preparations which may be lacking its natural gelforming mucins. It is pH sensitive, and becomes more viscous when exposed to the pH of the ocular surface, forming a gel-like network, and enabling the tears to adhere again. It may also reduce the friction of lid wiper epitheliopathy. Sodium hyaluronate (Hyaluronic acid) Hyaluronic acid (HA) occurs naturally in skin, synovial joints, aqueous humour and vitreous humour. For years it has been used by ophthalmologists in cataract and other ocular surgery. It is used as a ‘wrinkle-filler’ or ‘plumper’ Figure 5 in minor cosmetic facial procedures, and can be found in antiwrinkle cosmetic creams. It has also been incorporated into contact lenses (Safegel). It is now available in several dry eye preparations (see Table below and on page 7). When the eye is open, the HA molecules are randomly tangled and very viscous. They act as a sponge, and delay tear evaporation and drainage. With the agitation of blinking, the HA molecules align, making it less viscous and more elastic, and enabling it to spread over the surface of the eye and lubricate it (Figure 4 see page 5). Phospholipids Phospholipids attempt to stabilise the lipid layer of the tears. Present in Clarymist and Optrex ActiMist, phosphatidylcholine, derived from soy lecithin, is also the most common phospholipid in healthy tears. These products are applied as a spray to the closed eye, eventually finding their way to the lid margins where they will be distributed by blinking. Clinitas Ultra 3 also contains lecithin PRODUCT LUBRICANT PRESERVATIVE CL USE P/GSL DISCARD NOTES AFTER Aquify Sodium hyaluronate 0.1% Sodium perborate Yes GSL 8 weeks Aqueous/General deficiency Avizor Comfort Drops Povidone 1% Polyhexanide 0.0002% Yes GSL 60 days Cl rewetting drop Avizor Moisture Sodium hyaluronate 0.1% Polyhexanide 0.0001% Yes GSL 60 days Aqueous/General Drops deficiency Avizor Moisture Sodium hyaluronate 0.1% None Yes GSL N/A Aqueous/General Drops Unit Dose deficiency Blink Contacts Sodium hyaluronate 0.15% None Yes GSL N/A Aqueous/General Unit Dose deficiency Blink Contacts Sodium hyaluronate 0.15% Ocupure 0.005% (1) Yes GSL 45 days Aqueous/General Multi-Dose deficiency Blink Intensive Sodium hyaluronate 0.2%, None Yes GSL N/A Aqueous/Mucous Tears Unit Dose Polyethylene glycol 400 0.25% deficiency Blink Intensive Sodium hyaluronate 0.2%, Ocupure 0.005% (1) Yes GSL 45 days Aqueous/Mucous Tears Multi-Dose Polyethylene glycol 400 deficiency Blink Refreshing Polyvinyl alcohol 1.4% None Yes GSL N/A For mild dry eye Unit Dose symptoms Blink Refreshing Polyvinyl alcohol 1.4% Ocupure 0.005% (1) Yes GSL 45 days For mild dry eye Multi-Dose symptoms Clarymist Soy lecithin 1.0% Phenoxyethanol 0.5% (1) Yes GSL 3 years Lipid deficiency (MGD) Clinitas Hydrate Carbomer 980 0.2% Cetrimide No GSL 4 weeks More severe dry eye or night use Clinitas Soothe Sodium hyaluronate 0.4% None Yes GSL N/A Highest HA content Clinitas Ultra 3 PVA, Povidone, Amisol Polyquaternium 42 Yes GSL 28 days Augments all 3 phases Hyabak Sodium hyaluronate 0.15% None (2) Yes GSL 8 weeks Aqueous/General deficiency Hycosan Sodium hyaluronate 0.1% None (2) Yes GSL 12 weeks Aqueous/General deficiency Ocusan Unit Sodium hyaluronate 0.2% None Yes GSL N/A Aqueous/General Dose deficiency Optive Sodiumcarboxy-methyl- Purite (1) Yes GSL 6 months Mucous/Aqueous cellulose 0.5%, Glycerin 0.9% deficiency
phospholipid in its ingredient Amisol, as well as PVP and PVA, and claims to enhance all three phases of the tear film. Electrolytes Many dry eye preparations, rather than simply diluting the tears to reduce osmolarity, also include naturally-occurring electrolytes, such as sodium, chloride, potassium and bicarbonate. Some aim exactly to mimic the electrolyte composition of normal tears, matching the osmolarity and thereby preventing further damage and helping to promote healing (eg TheraTears). Availability In the UK, drugs may be classed as either: POM (prescription only medicines); P (available without prescription at a pharmacy); or GSL (general sales list, available in nonpharmaceutical outlets such as optical practices and supermarkets). Pharmacy (P) dry eye preparations are also available to optometrists to supply but not at present to dispensing opticians or contact lens opticians. Most of the products listed in the table are general sales list (GSL) and hence freely available. Which are the best products to stock? Unless a practice is specialising in dry eye and its management, it may be best to avoid duplication. One approach might be to carry one of the products containing sodium hyaluronate or, if space allows, perhaps two, in differing concentrations. These products represent good, general purpose dry eye preparations. Connttinuuinngg Eduucationn and Trainninng Applying eye drops (Photograph courtesy of TheraTears) One of the liposomal sprays (containing soy lecithin) would be useful for those patients in whom the problem is obviously evaporative in nature, eg in meibomian gland Continued overleaf PRODUCT LUBRICANT PRESERVATIVE CL USE P/GSL DISCARD AFTER NOTES Optrex Dry Eye Sodium hyaluronate 0.15% Oxyd (1) Yes GSL 4 weeks Aqueous/General Drops deficiency Optrex Actimist Soy lecithin 1.0% Phenoxyethanol 0.5% (1) Yes GSL 3 years Lipid deficiency (mgd) Oxyal Sodium hyaluronate 0.1% Oxyd (1) Yes GSL 4 weeks Aqueous/General deficiency Refresh Contacts Sodiumcarboxymethylcellulose 0.5% Purite (1) Yes GSL 45 days Cl rewetting drop Refresh Contacts Sodiumcarboxy- None Yes GSL N/A Cl rewetting drop Unit Dose methylcellulose 0.5% Refresh Soothe and Sodiumcarboxy- None Yes GSL N/A Mucous/Aqueous Protect Unit Dose methylcellulose 1% deficiency Systane Hydroxpropyl guar, Poly- Polidronium chloride 0.001% Yes (3) GSL 6 months Mucous/Aqueous ethylene glycol 400 0.4%, Propylene glycol 0.3% deficiency Systane Unit Dose Hydroxpropyl guar, Poly- None Yes (3) GSL N/A Mucous/Aqueous ethylene glycol 400 0.4%, Propylene glycol 0.3% deficiency Tears Naturale Dextran 70 0.1% Benzalkonium chloride No P 1 month General purpose Hypromellose 0.3% 0.01% lubricant Theratears Eye Sodiumcarboxy- None Yes GSL N/A Electrolyte- Drops Unit Dose methylcellulose 0.25% balanced Theratears Liquid Sodiumcarboxy- None Yes GSL N/A Electrolyte- Gel Unit Dose methylcellulose 1% balanced Viscotears Carbomer 980 0.2% Cetrimide 0.1mg/g No P 1 month More severe dry eye or night use Vislube Unit Dose Sodium hyaluronate 0.18% None Yes GSL N/A Aqueous/General deficiency Vismed Light Sodium hyaluronate 0.1% Polyhexanide Yes GSL 4 weeks Aqueous/General deficiency Vismed Multi Sodium hyaluronate 0.18% None (2) Yes GSL 3 months Aqueous/General deficiency Vismed Unit Dose Sodium hyaluronate 0.18% None Yes GSL N/A Aqueous/General deficiency Vismed Gel Unit Dose Sodium hyaluronate 0.3% None Yes GSL N/A High HA content (1) Vanishing preservative (2) <strong>Dispensing</strong> system prevents contamination of contents (3) Use before insertion and after removal
Page 1: dispensingoptics July 2009 Dispensi
Page 4 and 5: 4 dispensingoptics July 2009 A drop
Page 8: 8 dispensingoptics July 2009 Figure
Page 11 and 12: sunglasses, lenses, practice manage
Page 14: 14 dispensingoptics July 2009 Well
Page 17 and 18: also offers a point of differentiat
Page 19 and 20: failing to comply with a PN, IN or
Page 21 and 22: General Secretary Tony Garrett and
Page 24: 24 dispensingoptics July 2009 Discu
Page 27 and 28: examination is free of charge under
Page 29 and 30: Dr Sarah Janikoun (left) with Kate
Page 31 and 32: Bodies herald joint AGM a turning p
Page 33 and 34: ABDO Cup Challenge is a breeze Part
Page 35 and 36: Optical supply chain link expanded
Page 37 and 38: We had a bit of a laugh at my expen
Page 39: Diary of events September 8 ABDO Go

Dispensing Optics - ABDO

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?