When substituting dorzolamide for another ophthalmic anti-glaucoma agent, discontinue the other agent after proper dosing on one day, and start dorzolamide on the next day. Hylo-Tear*** 0.1% or Hylo-Forte*** 0.2%. 300 drops metered dose bottle, 6m expiry. Can prescribe ComplEYE aid. Suitable for treatment of mild, moderate and severe dry eyes, providing long-lasting relief from eye discomfort and dryness; including post-surgery treatment The following side effects have been reported with dorzolamide preservative free either during clinical trials or during post-marketing experience:

For patients who are allergic to lanolin, alternative lanolin-free eye ointment can be obtained from specialist. For patients with moderate episodic or chronic discomfort with or without environmental stress. Episodic visual symptoms which are annoying and/or activity-limiting. Hydroxypropyl guar or combination product containing trehalose can be used for more severe symptoms as they can reduce inflammation and protect ocular surface. There is a potential for an additive effect on the known systemic effects of carbonic anhydrase inhibition in patients receiving an oral carbonic anhydrase inhibitor and dorzolamide. The concomitant administration of dorzolamide and oral carbonic anhydrase inhibitors is not recommended. Choroidal detachment concomitant with ocular hypotony have been reported after filtration procedures with administration of aqueous suppressant therapies.

Conditions treated

Try to minimise environmental factors by taking regular breaks from working on VDUs and increasing humidity of rooms where possible. Review medications that may aggravate dry eyes e.g. antihistamines. Ask about OTC medication. Treat underlying condition. Blepharitis is the most common Meibomian Gland Dysfunction (MGD) producing dry eye symptoms. Dry eye is one of the self-care conditions for which eye drops are available OTC and should not be routinely prescribed in primary care. ( Leeds CCG Guidance). Treatment should include applying warmth using ‘eye bags’ (available over the counter) and eyelid hygiene. Patient self help guide. There is some evidence that a diet rich in omega-3 fats may improve symptoms. Patients with symptoms suggestive of Sjogren's syndrome should be referred for ophthalmologist review. Vizidor contains dorzolamide hydrochloride, a potent inhibitor of human carbonic anhydrase II. Following topical ocular administration, dorzolamide reduces elevated intra-ocular pressure, whether or not associated with glaucoma. Elevated intra-ocular pressure is a major risk factor in the pathogenesis of optic nerve damage and visual field loss. Dorzolamide does not cause pupillary constriction and reduces intra-ocular pressure without side effects such as night blindness or accommodative spasm. Dorzolamide has minimal or no effect on pulse rate or blood pressure.

Pharmacotherapeutic group: Antiglaucoma preparations and miotics, Carbonic Anhydrase Inhibitors, dorzolamide, ATC code: S01EC03 The patient should instill one drop in the affected eye(s) as directed by the physician. The patient should blink a few times so that the drop spreads over their eye should be instructed to seek advice from their doctor, pharmacist or nurse if they are not sure how to administer their medicine. Consider preservative-free (PF) treatment options containing carmellose or sodium hyaluronate. See formulary table below. If blepharitis or evaporative dry eye: use Systane Balance (propylene glycol 0.6%) or Optive Plus (carboxymethylcellulose 0.5%, glycerine 1%, castor oil), 10ml, 6m expiry.The management of patients with acute angle-closure glaucoma requires therapeutic interventions in addition to ocular hypotensive agents. Dorzolamide has not been studied in patients with acute angle-closure glaucoma.

superficial punctate keratitis, tearing, conjunctivitis, eyelid inflammation, eye itching, eyelid irritation, blurred visionFormulated to be naturally kind to eyes, Vizulize Intensive Dry Eye Drops are pH balanced to the eye’s tear fluid so as not to sting on application.

If you develop allergic reactions including hives, swelling of the face, lips, tongue, and/or throat which may cause difficulty in breathing or swallowing, you should stop using this medicine and seek immediate medical advice. After all doses have been used there will be some Vizidor left in the bottle. The patient should not be concerned since an extra amount of Vizidor has been added and the patient will get the full amount of Vizidor that their doctor has prescribed. Using the excess medicine remaining in the bottle after the patient has completed the course of treatment should not be attempted. The bottle should be held directly below the cap and the cap should be turned to open the bottle. To avoid contamination of the solution, the tip of the bottle must not touch anything.Buffered solution with Calendula extract, Hamamelis extract, EDTA 0.12%, PHMB 0.0001%. Storage instructions When using nasolacrimal occlusion or closing the eyelids for 2 minutes, the systemic absorption is reduced. This may result in a decrease in systemic side effects and an increase in local activity. If more than one topical ophthalmic drug is being used, the drugs should be administered at least ten minutes apart.