Instilling eye drops
- There is potential for interaction with some systemic drugs. For example, phenylephrine may interact with systemically administered monoamine-oxidase inhibitors and anti-hypertensive drugs.
Making the appointment
- If pupils are likely to be dilated, tell patients when they make an appointment that they might not be able to drive after the examination. Suggest that they bring sunglasses with them.
- When you use drugs that dilate the pupil, you should consider whether to:
- check the depth of the anterior chamber, for example using the van Herick technique, for the possibility of angle closure, and
- measure intra-ocular pressures as appropriate, for example before and/or after dilation.
- The NHS Diabetic Eye Screening Programme does not consider these checks necessary when using tropicamide alone.
- You should ask the patient if they:
- have experienced adverse reactions to eye drops in the past
- have a history of drug-induced adverse incidents
- have any relevant medical conditions, or
- take any systemic drugs.
- You should check for possible interactions with any systemic medication the patient may be taking.
- You should record all drugs used, including the batch number and expiry date, on the patient record.
- You may keep a logbook of which drugs are used on each patient. This will help you if you need to recall patients.
- You should explain to the patient:
- 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, and
- what to do if they experience an adverse reaction.
- You should instruct the patient to attend the local Accident and Emergency department if you are not available to deal with any emergency or adverse reaction that may arise following the instillation of the drug.
- You should inform the patient’s GP of any suspected adverse reaction. See also para A398.
Delegating the instillation of eye drops
- There is no legal restriction on who can instil eye drops to a person as the law only restricts supply of the drops.
- You are responsible for the instillation and if you decide to delegate this to another member of staff you must be on the premises whilst this is being done so you can intervene if necessary.133 You are responsible for the management of the patient and the work of the person to whom you have delegated the procedure. See section on Working with colleagues.
131 General Optical Council (2016) Standards of practice for optometrists and dispensing opticians para 7.6 [Accessed 22 Oct 2017]
132 College of Optometrists. Patient leaflets, instillation of eye drops, tear-off pads [College members only] [Accessed 30 Oct 2017]
133 General Optical Council (2016) Standards of practice for optometrists and dispensing opticians para 9.3 [Accessed 22 Oct 2017]