- You must act in accordance with the current legislation controlling the use and supply of drugs in optometric practice.
- You should take particular care when using or supplying drugs to patients in at-risk groups.
- You must be aware of the indications, cautions, contraindications and side effects of any drugs you instil or supply.
- You must tell patients how to use the drug you supply and what to do in the event of an adverse incident following instillation of eye drops or supply of a drug.
- You should tell a patient to attend the local Accident and Emergency department if you are not available to deal with an emergency or adverse reaction following the instillation of eye drops or supply of a drug.
- You may delegate the instillation of eye drops to another member of staff but you remain responsible for the patient.
- You should not treat yourself or someone close to you, or prescribe or prepare written orders for prescription-only medicines (POM) for yourself or someone close to you, except in the cases of minor ailments or emergencies.
- You should store all drugs according to the manufacturer’s instructions.
- You should report adverse reactions to medicines or medical devices using the appropriate reporting schemes.
- actions
- interactions
- cautions
- contraindications
- side effects.
References
148 Human Medicines Regulations 2012 SI 1916.149 MHRA. Medical devices regulation and safety: detailed information [Accessed 19 Nov 2020]
150 The College of Optometrists Optometrists’ Formulary [Accessed 19 Nov 2020]
- consider alternative options and only prescribe antimicrobials when this is clinically appropriate
- be aware of local guidelines on antimicrobial prescribing
- not issue an immediate prescription for an antimicrobial to a patient who is likely to have a self-limiting condition
- only issue repeat prescriptions for antimicrobials if these are needed for a particular clinical condition or indication.
References
151 National Institute for Health and Care Excellence (2015) NG15 Antimicrobial Stewardship Accessed 19 Nov 2020]- check the depth of the anterior chamber, for example using the van Herick technique, for the possibility of angle closure
- measure intra-ocular pressures as appropriate, for example before and/or after dilation.
- have experienced adverse reactions to eye drops in the past
- have a history of drug-induced adverse incidents
- have any relevant medical conditions
- take any systemic drugs.
- that you are administering the correct drug and dosage
- the expiry date.
- why you are instilling the drug
- what effects the drops might have
- how long the effects might last
- the side effects they might experience
- if you are dilating their pupils, that they might not be able to drive and must not undertake any activity which is not advised after dilation, and for how long
- if you are using anaesthetic drops, that they should avoid wearing contact lenses for an appropriate period of time after anaesthesia
- what to do if they experience an adverse reaction.
References
152 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians para 7.6 [Accessed 19 Nov 2020]153 The College of Optometrists. Instillation of eye drops tear-off pads (College members only) [Accessed 19 Nov 2020]
154 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians para 9.3 [Accessed 19 Nov 2020]
- all medicinal products on a General Sale List (GSL)
- all pharmacy (P) medicines.
References
155 The College of Optometrists Optometrists’ Formulary [Accessed 19 Nov 2020]156 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians para 2.5 [Accessed 19 Nov 2020]
157 General Optical Council (2016) Standards of Practice for Optometrists and Dispensing Opticians, para 7.3 [Accessed 19 Nov 2020]
- you are treating minor ailments, or
- it is an emergency.
- record this in the patient notes, including your relationship to the patient and the reason for the necessity of prescribing
- tell the patient’s GP and others treating the patient, if relevant, what you have prescribed and other information required for continuity of care, unless the patient objects.
References
158 General Medical Council (2013) Good practice in prescribing and managing medicines and devices [Accessed 19 Nov 2020]References
159 MHRA (2017) Patient Group Directions [Accessed 19 Nov 2020]- store all diagnostic and therapeutic drugs according to the manufacturer’s instructions, and
- keep drugs out of patients’ reach.
References
160 Environmental Protection Act 1990 s34 [Accessed 19 Nov 2020 2020]161 The College of Optometrists (2014) Guidance on the disposal of waste [Accessed 19 Nov 2020]
- the yellow card scheme which covers systemic adverse reactions to ocular medicines and ocular reactions to systemic medication162
- the Medical Devices Reporting Form which covers adverse incidents mainly relating to contact lenses and care products, including contact lens comfort drops.163
References
162 MHRA Yellow Card Scheme: guidance for healthcare professionals, patients and the public [Accessed 19 Nov 2020]163 MHRA. Report a problem with a medicine or medical device [Accessed19 Nov 2020]
The College of Optometrists Optometrists’ Formulary [Accessed 19 Nov 2020]
The College of Optometrists Clinical Management Guidelines [Accessed 19 Nov 2020]
The College of Optometrists Guidance for Optometrist Prescribers [Accessed 1 Aug 2019]
The College of Optometrists higher qualification in independent prescribing [Accessed 19 Nov 2020]
The College of Optometrists: information and guidance on myopia management [Accessed 19 Nov 2020]
The College of Optometrists patient information on the instillation of eye drops (tear off pad) [Accessed 19 Nov 2020]
National Institute for Health and Care Excellence (2015) NG15 Antimicrobial Stewardship [Accessed 19 Nov 2020]
National Institute for Health and Care Excellence (2016) Quality Standard QS121: Antimicrobial stewardship [Accessed 19 Nov 2020]
Royal Pharmaceutical Society (2016) A Competency Framework for all Prescribers [Accessed 19 Nov 2020]