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Minor Eye Condition Services Dear Pharmacist Colleague, January 2017 What is the Minor Eye Conditions' Service (MECS)? The Minor Eye Conditions' Service provides assessment and treatment for people with recently occurring minor eye conditions. The service is provided by MECS accredited optometrists across Oxfrodshire who have specialist knowledge, training and skills. Minor eye conditions that can be treated by the service include: - Red eye or eyelids - Dry eye gritty and uncomfortable eyes - Irritation and inflammation of the eye - Significant recent sticky discharge from the eye or watery eye - Recently occurring flashes and floaters - Painful eye - Ingrowing eyelashes - Recent and sudden loss of vision - Foreign body in the eye We have launched The Minor Eye Casualty Service (MECS) in Oxfordshire in August 2016. Some eye conditions are better suited to immediate referral to Eye Casualty. Patient should go directly to eye casualty if they have any of the following symptoms: Worst ever painful, red eye Recent trauma or surgery to the eye Sudden, sustained loss of vision (less than 48 hours) Sudden onset double vision (less than 48 hours) Sudden onset flashes (less than 1 week) with blur, veils, curtains in vision Swollen eyelids with red, painful, bulgy eye, double or blurry vision Transient vision loss with headaches and soreness of scalp or jaw Painful eye with droopy eyelid, double vision and large pupil size. Previous history of iritis or anterior uveitis If you are unsure whether someone’s symptoms can be assessed and treated by the service, you are advised to contact one of the participating optometry practices who will advise you. NOTE: If you have someone presents with an eye condition that is being regularly monitored by your optometrist or hospital eye service, this will not be covered by MECS; for example cataracts, diabetic retinopathy or glaucoma. CONTACT LENS PATIENTS with contact lens related eye problems need to see their own Optometrist, they are not eligible for a MECS appointment. Who is the service for? The service is for people registered with an Oxfordshire GP. It is for people of aged 6 and above. Children under 16 years must be accompanied at their appointment by an adult. How do Patients book an appointment with the service? The service is provided by a number of MECS registered optometrists across Oxfordshire. A list of participating optometrists can be found using this link: http://www.oxfordshireloc.org.uk/files/5414/8241/2243/Patient__List_of_MECS_Oxon_Participating_Practices_Jan_2017.pdf A patient can telephone an approved optometrist directly (self-refer) to make an appointment. On contacting the optometry practice, the patient will be asked some questions about their symptoms in order to assess how quickly they need to be seen by the service. Depending on the symptoms, the patient will be seen contacted within 4 hours and an appointment offered within 48 hours if applicable. Appointments are available during normal working hours. Some optometry practices offer appointments at the weekend. Under MECS Optometrists can supply the patient a range of ophthalmic medications a that are CCG approved directly or via written order to pharmacists. These are listed in the table below. As MECS is an NHS service the Optometrist must offer the range of ophthalmic medications below under the NHS first. The CCG does not support the prescribing of antihistamine drops by GPs so Optometrists are advised to encourage these to be bought OTC. In order to help the decide the best option for the patient, the table below has been forwarded to all Optometrists. Medication Chloramphenic ol Chloramphenic ol Fucithalmic2 Hypromellose3 Carbomer 980 (Viscotears) Liquid Parrafineye ointment Lacri-lube Antazoline and Xylometazoline (Otrivine-antistin) Sodium Cromoglicate5 Sodium Hyaluronate NHS Price Trad e Price Retail price* * Form Strength Quantit y Eye drops* 0.50% 10ml £1.12 £5.991 1% 4g £1.63 £5.991 1% 0.30% 5g 10ml £29.06 £0.81 POM £1.53 0.20% 10g £2.80 £4.724 Eye ointment* Eye drops Eye drops Eye gel 3.5 5g £2.94 / £3.88 or Eye drops 0.5%/0.05 % 10ml £2.35 Eye drops 2% 10ml /13.5ml £2.06 10ml variou s Preservativ e Free 0.10% Hylo-Tear 0.2% Hylo-Forte £4.48 £10.50 6 NHS price: what GPs are charged if the item is written on prescription. Trade price: what pharmacies pay to purchase the product. Pharmacies then put their own mark up on these prices. Retail price: a guide to what pharmacies might sell the product to a customer for, but prices are likely to vary. The OTC preparation of Chloramphenicol eye drops / ointment is only licensed for acute bacterial conjunctivitis; pharmacists cannot sell it for any other condition. The preparation kept in the dispensary is POM so cannot be sold to the public 1 Fucithalmic® (Fusidic Acid) is only available on prescription and must be prescribed as generic Fusidic Acid as the branded product no longer exists. 2 3 Price for Visco-Tears but other brands available Sodium cromoglicate eyedrops are POM but several brands are available to purchase OTC eg Optrex Allergy® £5.99, Pollenase £4.59, Opticrom Allergy £3.35 4 Following an appointment If the patient can obtain their medications via their GP then the following occurs: 1. The prescription request is emailed to the G.P and the patient needs to go their GP practice. 2. If the patient is exempt from paying for NHS prescriptions their prescription is free on collection. If not, they will need to pay: – This is identical to any other NHS prescirption and it does not involve the MECS Optometrist needing to know about exemption. Alternatively, the patient can buy the medications from the Optometrist (where applicable) or take the recommended drug request to the pharmacist and pay. The patient will always be offered their medications via their GP first. If you need to contact us about this service, please email: [email protected]