Lothian Joint Formularies - Child

Prescribing Notes

• These preparations are available over–the–counter.
• Chronic soreness of the eyes due to reduced / abnormal tear secretion often responds to tear replacement therapy. The severity of the condition and patient preference will often guide the choice of preparation.
• Frequent instillation of drops (e.g. hourly hypromellose) may cause a sensitivity reaction to the preservative in the drops. There are several preservative–free artificial tear preparations available e.g. Artificial Tears Minims^®, Liquifilm Tears^® single dose units. There is also a relatively cheap multi–dose hypromellose preservative– free available from Moorfields (bottle keeps for 1 week in the fridge after opening). Hypromellose eye drops is the traditional choice of treatment for tear deficiency. It is the cheapest and the least viscous.
• Acetylcysteine 5% with hypromellose 0.35% (Ilube^®) drops is useful as a mucolytic agent.

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 used for diagnosis of naso–lachrymal duct patency.
• For detection of corneal abrasions, strips are preferred since the drops may not fluoresce properly if too much is instilled into the eye.

Other eye preparations

For specialist use only:

• Mydricaine No. 2 injection should not be used in children. Mydricaine No. 1 injection (children) is used for rapid dilation of the pupil in iritis and uveitis. Dose: up to 0.3mL by subconjunctival injection. Each 0.3mL of No. 1 injection (children) contains procaine HCl 3mg, atropine sulphate 0.5mg, and adrenaline solution (1 in 1000) 0.06mL.