Eye procedures and diagnostics
For general guidance on administration of drugs to the eye and control of microbial contamination of eye drops, please see the ‘General information on eye drops’ section.
Antimuscarinic.
Apply 1 drop prior to examination.
Apply 1 drop prior to examination.
One ophthalmic insert per operated eye, a maximum of 2 hours before surgery or the investigative procedure.
Phenylephrine can be used with cyclopentolate or tropicamide.
Apply 1 drop prior to examination.
Apply 1 drop prior to examination.
Used to supplement the mydriatic effect of the antimuscarinics. Only the 2.5% strength is listed; the 10% strength is rarely used due to transient high blood pressure concerns.
Apply 1 drop prior to examination.
Prescribing Notes:
- Antimuscarinics dilate the pupil (mydriasis) and paralyse the ciliary muscle (cycloplegia).
- Tropicamide is short-acting (4-6 hours) and is a useful mydriatic prior to examining the eye. The BNF advises caution as mydriasis may precipitate acute angle-closure glaucoma in a very few patients who are hypermetropic (long-sighted) and predisposed to the condition because of a shallow anterior chamber. However, the risk is so minimal that this should not be regarded as a contra-indication to its use for diagnostic purposes.
- All mydriatics can cause blurred vision and patients should be warned not to drive until this has settled (usually after 1-2 hours).
- All patients having pupil dilation should be advised to seek medical advice if acute pain develops after administration of drops as acute angle-closure glaucoma can occur.
- Cyclopentolate has a shorter duration of action (up to 24 hours).
- Phenylephrine may be used to supplement the mydriatic effect of these.
- Phenylephrine is used as a mydriatic prior to ophthalmic procedures. Its effect lasts up to seven hours.
- Toxic systemic reactions to atropine and cyclopentolate in the very young and very old are possible.
- Patients should be warned not to drive for several hours after mydriasis.
History Notes
15/06/2022
East Region Formulary content agreed.
1 drop repeated if necessary.
1 drop repeated if necessary.
Apply as required.
Apply as required.
Prescribing Notes:
- Oxybuprocaine is the recommended local anaesthetic for use before ophthalmic procedures e.g. tonometry. It has a very rapid onset of action (about 30 seconds).
- Tetracaine eye drops produce a more profound anaesthesia than oxybuprocaine and are suitable for use before minor surgical procedures. It has a temporary disruptive effect on the corneal epithelium.
- Local anaesthetic drops should never be used for the symptomatic control of pain because of corneal epithelium toxicity.
- Proxymetacaine 0.5% eye drops (Minims) cause less initial stinging than oxybuprocaine and is useful in children. May also be used before the instillation of mydriatic/cycloplegic drops for refraction, which sting on instillation.
History Notes
15/06/2022
East Region Formulary content agreed.
Instil one drop as required.
Prescribing Notes:
- Fluorescein ophthalmic strips are used to detect corneal abrasions/lesions and foreign bodies. They are also used in tonometry.
- Fluorescein eye drops are usually only used for diagnosis of naso-lachrymal duct patency and leakage of eye wounds.
- For detection of corneal abrasions, strips are preferred since the drops may not fluoresce properly if too much is instilled into the eye.
History Notes
15/06/2022
East Region Formulary content agreed.
Specialist advice.
Prescribing Notes:
- Apraclonidine 1% eye drops (Iopidine) may be used as a diagnostic test for investigation of possible Horner’s Syndrome. A once only test to be carried out in the eye dept, NOT for ongoing use.
History Notes
15/06/2022
East Region Formulary content agreed.
Antimuscarinic
1 drop, 20 minutes before examination
1 drop, 20 minutes before examination
Sympathomimetic
1 drop, 20 minutes before examination
Prescribing Notes:
- Tropicamide is short-acting (up to 3 hours) and is a useful mydriatic prior to examining the eye. It can cause blurred vision.
History Notes
29/07/2020
Content migrated from LJF website.
1 drop repeated if necessary
Prescribing Notes:
- Local anaesthetic drops should never be used for the symptomatic control of pain because of corneal epithelium toxicity.
- Proxymetacaine 0.5% eye drops (Minims) cause less initial stinging and is useful in children e.g. before the instillation of mydriatic/cycloplegic drops for refraction, which sting on instillation.
History Notes
29/07/2020
Content migrated from LJF website.
Instil one drop as required
Instil one drop as required
Prescribing Notes:
- Fluorescein ophthalmic strips are used to detect corneal abrasions/lesions and foreign bodies. They are also used in tonometry. They are also used in tonometry.
- Fluorescein eye drops are usually only used for diagnosis of naso-lachrymal duct patency and leakage of eye wounds.
- For detection of corneal abrasions, strips are preferred since the drops may not fluoresce properly if too much is instilled into the eye.
History Notes
29/07/2020
Content migrated from LJF website.