It is estimated that up to 8 million people suffer from dry eyes in the UK and that up to 1 in 3 patients aged 65 years or older suffer from dry eye symptoms3.
Dry eye syndrome, or dry eye disease, is a common condition that occurs when the eyes don’t make enough tears, or the tears evaporate too quickly. This leads to the eyes drying out and becoming red, swollen and irritated. Dry eye syndrome is also known as keratoconjunctivitis sicca.
Nationally recognised guidelines from both Moorfields, NICE and PrescQIPP include the use of ocular lubricants as part or the treatment pathway for patients with dry eye syndrome.
Moorfields Eye Hospital NHS Foundation Trust is the leading provider of eye health services in the UK and a world-class centre of excellence for ophthalmic research and education. Moorfields has developed clinical recommendations for identification and treatment of dry eye conditions both within primary and secondary care settings4 (treatment extract below).
Tear substitutes: mild to moderate cases of dry eye syndrome can usually be successfully treated using over-the-counter artificial tear drops; if a patient has severe symptoms, and needs to use eye drops more than six times a day, or if they wear contact lenses, advise them to use preservative-free eye drops
Eye ointment can also be used to help lubricate eyes, but it can often cause blurred vision, so it is probably best used only at night
More severe cases may require specialist medication or lacrimal punctal plugs
Moorfields prescribing guidelines for Ocular Lubricants1 lists Carmellose and preservative free Sodium Hyaluronate as treatment options for patients presenting with mild to severe dry eyes.
|MILD dry eyes||MODERATE dry eyes||SEVERE dry eyes|
|Hypromellose 0.3% (Preserved)||Sodium Hyaluronate 0.1% (unpreserved)||Sodium Hyaluronate 0.1% (unpreserved)|
|Carmellose 0.5% (Preserved/unpreserved)||Carmellose 1.0% (unpreserved)||Sodium Hyaluronate 0.2% (unpreserved)|
|Carbomer 980 0.2% (Preserved/unpreserved)||Carbomer 980 0.2% (Preserved/unpreserved)||Liquid Paraffin Ointment|
Preservative-free products should be prescribed for the following patient groups:
CKS advocate the use of eye lubricants as part of the treatment pathway for management of patients presenting with dry eye (treatment extract below)
Highlights treatment options for dry eyes and the use of preservative free products (extract below).
In 2018, NHSE issued guidance to CCGs advocating a reduction in prescribing for conditions that are suitable for self care5 known as “Conditions for which over the counter items should not routinely be prescribed in primary care: Guidance for CCG’s.” Within the guidance are recommendations for the prescribing of products used to treat dry eyes which includes the following recommendations:
CCG’s will be expected to reduce prescribing costs for dry eyes and the other conditions listed within the guidance and their performance will be monitored.
The VIZ Rx ocular lubricant range presents clinicians with a cost-effective range of products containing carmellose and sodium hyaluronate in a range of strengths and combinations for the treatment of mild, moderate and severe dry eyes. The preservative free formulations are in line with national guidelines and can be used in all patient groups, including those wearing soft contact lenses, with preservative allergy or epithelial toxicity; and those on long term or multiple treatments. The range is both cost effective and available OTC as Vizulize in line with NHSE guidance on promotion of self-care.