NHS Greater Glasgow & Clyde Area Drug and Therapeutics Committee
Greater Glasgow and Clyde Medicines
Medicines Update

Safe prescribing of corticosteroid eye drops

Potential patient safety concerns were raised to East Dunbartonshire prescribing group relating to patients inadvertently continuing to use corticosteroid eye drops beyond the recommended duration.

A local audit of patients after cataract surgery showed that patients are supplied with corticosteroid eye drop from the clinic which are normally used for approximately four weeks after surgery until specialist review. The patients can request further supplies of drops from their GP practice, which is appropriate in the short term since they may use up their initial supply. There is concern that by requesting further prescriptions, patients may continue to use the drops beyond the recommended duration. It is important that the duration of corticosteroid eye drop treatment is stated on the discharge information provided to the GP practice. Work is ongoing with ophthalmology to help resolve this issue.

The Medical and Dental Defence Union of Scotland (MDDUS) have previously published a case study on prescribing of steroid eye drops for a patient with iritis. A lack of clear information and many repeat prescriptions issued without review or assessment over a number of years led to cataract formation.

 

Learning Points

For ophthalmology clinics

  • Ensure that the intended duration of corticosteroid eye drops is clearly stated on the discharge information.
  • Advise the patients on duration of treatment and reasons for the short treatment course.

 For GP practices

  • If the duration of treatment is not stated on the discharge information, clarify the detail with the hospital clinic.
  • Do not issue corticosteroid eye drops on repeat prescription.
  • Consider adding duration of treatment to directions on acute prescription.