Ocular Diagnostic and Peri-Operative Preparations and Photodynamic Treatment

Specialist initiation (S¹)

FLUORET STRIPS^®

• Used to detect corneal abrasions/lesions and foreign bodies.

• They are also used in tonometry.

• Primary care = may be ordered by medical practitioners on Form GP10A only.

FLUORESCEIN 1% or 2% eye drops

• Eye drops are usually only used for diagnosis of naso–lachrymal duct patency and leakage of eye wounds.

Specialist use only (S²)

KETOROLAC 0.5% eye drops

DICLOFENAC SODIUM 0.1% eye drops

NEPAFENAC 1mg/ml eye drops

• Indication: Reduction in the risk of postoperative macular oedema associated with cataract surgery in diabetic patients.

FLURBIPROFEN 0.03% eye drops 0.4ml unit dose

• Indication: The inhibition of intraoperative miosis. Flurbiprofen does not have intrinsic mydriatic properties and does not replace mydriatic agents.
• Also for the management of post-operative and post-laser trabeculoplasty inflammation in the anterior segment of the eye in patients in whom steroid therapy is not recommended.

Specialist use only (S²)

RANIBIZUMAB 10mg/ml solution for intravitreal injection

Indications:

• Visual impairment due to choroidal neovascularisation secondary to pathologic myopia in adults.
• Visual impairment due to macular oedema (MO) secondary to retinal vein occlusion (RVO) (branch RVO or central RVO) in adults.
• Visual impairment due to diabetic macular oedema (DMO) in adults with best corrected visual acuity (BCVA) 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline.

BROLUCIZUMAB 120mg/ml solution for intravitreal injection

• Indication: Treatment of neovascular (wet) age-related macular degeneration (AMD).

• MHRA Drug Safety Update January 2022: Brolucizumab (Beovu^®): risk of intraocular inflammation and retinal vascular occlusion increased with short dosing intervals

• Maintenance doses of brolucizumab (after the first 3 doses) should not be given at intervals of less than 8 weeks apart.

AFLIBERCEPT 40mg/ml and 114.3 mg/mL solution for intravitreal injection (Eylea^®)

Indications:

• Treatment of neovascular (wet) age-related macular degeneration.
• Visual impairment due to macular oedema secondary to central retinal vein occlusion.
• Visual impairment due to macular oedema secondary to branch retinal vein occlusion.
• Visual impairment due to diabetic macular oedema (DMO).
  SMC Restriction: adults with best corrected visual acuity (BCVA) 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline.
• Visual impairment due to choroidal neovascularisation secondary to pathologic myopia in adults.

FARICIMAB solution for intravitreal injection (Vabysmo^®)

Indications:

• Treatment of adult patients with visual impairment due to macular oedema secondary to retinal vein occlusion (branch RVO or central RVO) (SMC2685). 
  • See NHS Lanarkshire Guideline 'Use of Vabysmo (Faricimab) for Macular Oedema Secondary to Retinal Vein Occlusion'. 
• For the treatment of adult patients with neovascular (wet) age-related macular degeneration (nAMD) (SMC2512).
• For the treatment of adult patients with visual impairment due to diabetic macular oedema (DMO).
  SMC restriction: treatment of visual impairment due to DMO in adults with best corrected visual acuity (BCVA) of 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline (SMC2499).