Hypromellose

• Most ocular lubricants may be purchased over the counter from a pharmacy at a cost less than the current prescription charge
  
  
• Hypromellose is the first line choice. The standard preparation is 0.3% and may be administered up to every hour if required
  
  
• Unpreserved hypromellose is a pharmaceutical special and should only be used where there is a proven allergy to or toxicity from preservative. It has an expiry of 1 week after opening. Other single use lubricating eye drops are available e.g. carmellose sodium 1% (Celluvisc®)
  
  
• Lacri-Lube® is included as a lubricating eye ointment. It may be used in combination with artificial tear drops and applied at night
  
  
• Lacri-Lube® contains lanolin-wool fat derivatives.
  
  
• Liquifilm®/SnoTears® and Viscotears®/GelTears® are included as useful second line agents
  
  
• Viscotears®/GelTears are thicker preparations and are used three to four times daily
  
  
• Preservative-free preparations of lubricants should be prescribed if used more than QDS regularly
  
  
• Sodium hyaluronate and Hydroxypropyl Guar are more expensive than other ocular lubricants but maybe more cost effective for patients who do not use an entire bottle every month as the drops remain sterile in the bottle for 6 months after opening.

Reference:

• 1) South Devon Joint Formulary - Eye (Accessed 14/5/17)