11.8.1 Tear deficiency, ocular lubricants, and astringents

General Guidance

Click here to see the Dry Eye Prescribing Guidelines

Click here to see the Dry Eye Pathway

• Chronic soreness of the eyes associated with reduced or abnormal tear secretion will often respond to tear replacement therapy.
• The severity of the condition, frequency of administration and patient preference often guides product choice.
• Hypromellose is the most common agent and should be considered as first line. However, it may require hourly administration. Additions of polymers may prolong its duration of action (e.g. Tears Naturale ®).
• Polyvinyl alcohol increases the persistence of the tear film and is useful if the natural mucin layer across the eye is reduced.
• Eye ointments may be useful to lubricate the eye surface. However, they may cause temporary visual disturbance, but may be especially useful to provide nighttime relief.

​Recommended drugs

See link above to dry eye syndrome pathway and choice of treatment

N.B. VitA-POS now recommended in place of Lacri-lube due to VitA-POS having a THREE MONTH expiry after first opening

VisuXL - option for severe dry eyes by consultant ophthalmology only

Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary

Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low