General information on eye drops

Prescribing Notes:

Drugs administered as eye drops penetrate directly into the globe through the cornea. Absorption may also occur into the general circulation via conjunctival vessels or from the nasal mucosa after drainage of excess preparation down through the tear ducts; this can produce systemic side effects. Systemic absorption can be reduced by ‘punctal occlusion’, i.e. pressing tightly with a finger on the inside corner of the eye for about half a minute after instilling the eye drop.
Eye drops should be instilled by pulling down the lower eyelid and putting one drop into the pocket that is formed. The eye should then be closed tightly for about a minute (or see ‘punctal occlusion’ above). The conjunctival fornix can only accommodate one drop; since any extra will overflow (possibly leading to systemic absorption), only one drop should be used.
Eye ointments are applied by starting at the inside corner of the eye and squeezing a thin line (about half a centimetre) along the inside of the lower lid, then blinking the eye.
Subconjunctival injection may be used to administer anti-infective drugs, mydriatics or corticosteroids for conditions not responding to topical therapy.
Soft contact lenses should not generally be worn while using eye drops containing preservatives, or eye ointments. For further information see BNF or the product literature.
If using different eye products, leave a period of about 5 minutes between applications. Instil ‘thinnest to thickest’ (i.e. aqueous drop, then suspension, then gel drop, then ointment last).
After using eye drops or eye ointment, patients should be advised not to drive or perform skilled tasks until vision is clear.
A preservative-free formulation may be prescribed, if available, for all formulary products if clinically necessary as an alternative option.

History Notes

30/07/2026

Regional formulary chapter launched.

Prescribing Notes:

Eye drops in multi-use containers for use in the community should be discarded 4 weeks after opening to avoid contamination, unless otherwise stated by the manufacturer.
Single dose units should be used once only and not re-used unless stated by manufacturer. They should not be used for more than one patient. Preservative-free preparations may be single use only or discarded a set time after opening as per manufacturer’s instructions. Specially manufactured (usually unlicensed medicine) preservative-free eye drops usually keep for 1 week in the fridge after first opening. Newer commercially manufactured preservative-free drops can keep for longer depending on the particular manufacturer’s instructions.
It is not generally necessary to use separate bottles for each eye (except immediately after eye surgery), but care should be taken to avoid touching the eye(s) during use to avoid contamination. Most drops do not need to be kept in a fridge, unless directed otherwise.

History Notes

30/07/2026

Regional formulary chapter launched.