In a multiple-dose, double-masked, active-treatment (multidose dorzolamide) controlled, two period crossover multiclinic study, the safety profile of dorzolamide preservative-free was similar to that of dorzolamide multidose. Limited clinical data in pediatric patients with administration of dorzolamide (preserved formulation) three times a day are available. (For information regarding pediatric dosing see section 5.1). Pharmaceutical preparations and substances and products for the eyes; eye drops, eye wash, eye lotions and eye moisturisers. VIZhyal 0.1% is a sterile, ophthalmic solution that soothes and moisturizes the ocular surface to alleviate symptoms associated with moderate dry eyes, such as burning, irritation and foreign body sensation. VIZhyal 0.1% acts as a humectant on the eye, providing relief of dry eye conditions, including those associated with the use of PC, infrequent blinking, medical treatments, atmospheric pollution, air conditioning, central heating, wind and sun.

Do not allow the tip of the multi dose container to touch the eye or areas around the eye It may become contaminated with bacteria that can cause eye infections leading to serious damage of the eye, even loss of vision. Dorzolamide has not been studied in patients with hepatic impairment and should therefore be used with caution in such patients. Do not touch your eye with the dropper tip, as doing so can scratch your eye and contaminate the solution inside the bottle. Formulated to be naturally kind to eyes, Vizulize Intensive Dry Eye Drops are pH balanced to the eye’s tear fluid so as not to sting on application. Patients generally have mild discomfort or episodic discomfort under environmental stress. No visual symptoms or episodic mild fatigue.

For patients who are allergic to lanolin, alternative lanolin-free eye ointment can be obtained from specialist.

Hydroxypropyl guar or combination product containing trehalose can be used for more severe symptoms as they can reduce inflammation and protect ocular surface. If a more viscous drop is required, use Clinitas Multi** 0.4% (sodium hyaluronate) PF eye drop. 10ml, approx. 200 drops, 3m expiry. In a multiple-dose, double-masked, active treatment (dorzolamide multidose) controlled, two period crossover multiclinic study, in 152 patients with elevated baseline intraocular pressure (baseline IOP ≥22 mmHg) in one or both eyes, dorzolamide preservative-free had an IOP-lowering effect equivalent to that of dorzolamide multidose. The safety profile of dorzolamide preservative-free was similar to dorzolamide multidose.When dorzolamide was given orally to simulate the maximum systemic exposure after long-term topical ocular administration, steady state was reached within 13 weeks. At steady state, there was virtually no free active substance or metabolite in plasma; CA inhibition in RBCs was less than that anticipated to be necessary for a pharmacological effect on renal function or respiration. Similar pharmacokinetic results were observed after chronic, topical administration of dorzolamide. Hylo-Tear*** 0.1% or Hylo-Forte*** 0.2%. 300 drops metered dose bottle, 6m expiry. Can prescribe ComplEYE aid. Suitable for treatment of mild, moderate and severe dry eyes, providing long-lasting relief from eye discomfort and dryness; including post-surgery treatment

Carbonic anhydrase (CA) is an enzyme found in many tissues of the body including the eye. In humans, carbonic anhydrase exists as a number of isoenzymes, the most active being carbonic anhydrase II (CA-II) found primarily in red blood cells (RBCs) but also in other tissues. Inhibition of carbonic anhydrase in the ciliary processes of the eye decreases aqueous humour secretion. The result is a reduction in intra-ocular pressure (IOP). Try to minimise environmental factors by taking regular breaks from working on VDUs and increasing humidity of rooms where possible. Review medications that may aggravate dry eyes e.g. antihistamines. Ask about OTC medication. Treat underlying condition. Blepharitis is the most common Meibomian Gland Dysfunction (MGD) producing dry eye symptoms. Dry eye is one of the self-care conditions for which eye drops are available OTC and should not be routinely prescribed in primary care. ( Leeds CCG Guidance). Treatment should include applying warmth using ‘eye bags’ (available over the counter) and eyelid hygiene. Patient self help guide. There is some evidence that a diet rich in omega-3 fats may improve symptoms. Patients with symptoms suggestive of Sjogren's syndrome should be referred for ophthalmologist review. Recommend overnight treatment with a paraffin-based PF eye ointment: Xailin Night or Hylo-Night (formerly known as VitA-POS) or HydraMed Night Eye Ointments, 5g. Preparations, substances and products for the eyes; eye lotions, eye moisturisers, cosmetic preparations for the eyes. Composition: 1.0% Carmellose sodium (carboxymethyl cellulose), boric acid, sodium tetraborate decahydrate, sodium chloride, water for injectionComposition: Sodium hyaluronate 0.1% sodium phosphate monobasic monohydrate, sodium phosphate dibasic dodecahydrate, sodium chloride, water for injection. Efficacy results in paediatric patients suggest that the mean IOP decrease observed in the dorzolamide group was comparable to the mean IOP decrease observed in the timolol group even if a slight numeric advantage was observed for timolol.

If IOP was inadequately controlled on dorzolamide or timolol gel-forming solution monotherapy, a change was made to open-label therapy according to the following: 30 patients <2 years were switched to concomitant therapy with timolol gel-forming solution 0.25% daily and dorzolamide 2% t.i.d.; 30 patients ≥2 years were switched to 2% dorzolamide/0.5% timolol fixed combination b.i.d. (twice a day). When using nasolacrimal occlusion or closing the eyelids for 2 minutes, the systemic absorption is reduced. This may result in a decrease in systemic side effects and an increase in local activity. Across both age cohorts approximately 70 patients received treatment for at least 61 days and approximately 50 patients received 81-100 days of treatment. Patients should also be instructed that ocular solutions, if handled improperly, can become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions. Prescribe generically or use most cost effective brand. For e.g. VIZcellose** 0.5% or VIZcellose** 1% PF eye drops. 10ml, 3m expiry.Sodium hyaluronate 0.1% - 0.2% eye drops. Use most cost effective brand. For e.g. Blink Intensive Tears. Consider switching to PF drops if using more than 8 times a day. irritation including redness, pain, eyelid crusting, transient myopia (which resolved upon discontinuation of therapy), corneal oedema, ocular hypotony, choroidal detachment following filtration surgery Put one drop in the affected eye(s) as directed by your doctor. Blink a few times so that the drop spreads over the eye. If you are not sure how to administer your medicine, ask your doctor, pharmacist or nurse. The bottle should be held directly below the cap and the cap should be turned to open the bottle. To avoid contamination of the solution, the tip of the bottle must not touch anything.