How to warn patients in my health area about proposals to restrict dry eye help.

[PhoenixEyes]

I would really like to see the list of 3,200 OTC items they speak of.

Sunscreen isn't prescription at the moment except in very rare cases unfortunately. When I was discharged from hospital after Toxic Epidermal Necrolysis the burns unit staff recommended I use high SPF sun cream due to the new skin potentially being thinner and easier to burn, plus I'm pale skinned. But when I asked dermatology for it to be put on prescription they said it wouldn't be possible as under current prescribing guidelines it's primarily OTC.

I've had eczema all my life and yes it can get bad, at its worse my hands were cracked and bleeding and painful to use. However after 2 decades of trying different lotions and creams I have found something that suits me and no longer suffer, I do get it on prescription. There is of course a billion creams and lotions out there that purport to make your skin amazing but lack evidence, it would be helpful to actually see the list of items to see what is and isn't being considered...

On another document related to this they mentioned that stuff like Omega 3 supplements have already been dismissed for being available on prescription due to inconclusive evidence as to their effectiveness. We already have to pay for Omega 3 out of pocket if we want to give it a go of our own accord so that's nothing new unfortunately.

[CharlieGreenEyes]

I might be cynical but can't help thinking out of the 3,200 items they speak of, those that many people will see as being only for minor, cheap to treat, and temporary conditions, will be highlighted.....

They refer to short-term conditions - but your eczema is something you've had all your life. I can see some people - especially those already struggling financially (certainly those who currently use foodbanks) going without medicines - and potentially costing the NHS more in the end due to complications.

I don't buy Omega 3 supplements. Too expensive - especially as I have to spend so much on eyedrops. I do get them on prescription, thanks to opthalmologist diagnosis, but never get enough and have to buy extra OTC. I buy flaxseeds for Omega 3 (tried the oil - various brands, all expensive, and didn't seem to help).

I don't think the eyebag is available on prescription - yet every single opthalmologist and optometrist I've seen raves about them. Hasn't done anything for me (after several years) so perhaps that's why it is only OTC (not enough evidence to it's effectiveness?). Thinking about though - the eyebag is relatively cheap. Surprised they aren't on prescription because if it works for some patients, surely it's cheaper than some other MGD/Dry eye treatments?

I thought some eczema creams were prescription-only? Sorry if I've got this wrong. Certainly some drops for eye infections are. I'm not sure whether they intend to make these OTC or what.

I think the most important issue is that the consultation doesn't seem aware of or is deliberately ignoring that many conditions (including DED) have varying levels of severity.

[PhoenixEyes]

The reason warm compress eye bags aren't on prescription may be the same as for eyelid wipes (e.g. Ocusoft Plus). Not because they are deemed ineffective but because they are classed as a physical "device" or "appliance" so they are not classed as a prescriptible "drug" like liquid medications (e.g. eye drops) and tablets. Confusing for sure.

Examples from some prescribing guidelines I found previously:
"Ocusoft Eyelid Scrub. We understand that Ophthalmology Dept have been asking practices to prescribe this product, however it is not prescribable on FP10 as it is a device, rather than a medicinal product."

"The Medicines Management team has recently received a query regarding the availability of cleansing pads for eyelids on NHS prescription. Lid-Care, Ocusoft and Supranettes eyelid wipes are appliances. They are not included in the approved list in the Drug Tariff and therefore should not be prescribed at NHS expense."

Steroid creams for skin problems like eczema are prescription only but moisturizer creams and lotions are available both OTC and on prescription. I was given various steroid creams and moisturizers over the years and finally found Dermol 500 is all I need (like dry eye everyone's different as to what suits them best). I have to use it as a soap replacement so I use a lot and prefer to get it on NHS subscription.

And yes the fact dry eye isn't even mentioned is disappointing. There are some eye drops I already get over the counter as the NHS alternatives irritate my eyes, would not be good if they made them all OTC only.

[CharlieGreenEyes]

I used to get eyelid wipes on prescription. I haven't dared ask my current GP for eyelid wipes - I feel I'm already pushing it by getting the amount of eyedrops I get on prescription (I go through 2-4 bottles a week), but my old GP (before I moved home) did prescribe these to me. Perhaps because the eye hospital wrote in their report that I needed them? I'm not sure.

Guess it's either a postcode lottery issue, or probably more likely seeing as more items are no longer available on prescription it's a cost-cutting exercise and they used to be available but no longer are.

[PhoenixEyes]

Oh nice. I was given a free sample box of Ocusoft Plus wipes and Meibopatch eye bag but have been buying replacements since via Amazon.

[CharlieGreenEyes]

It would be great if Amazon offered a loyalty points scheme - like a free purchase for every 10 or something, the amount of money I've spent with them (on eye stuff).... They're cheaper than other chemists like Boots I've found.

It's always good to get free samples isn't it.

[PhoenixEyes]

Butterflies Eyecare do a points system, I sometimes order from them but don't often reach the free delivery margin so mostly order via Amazon. There are sites where you can earn Amazon vouchers like swagbucks, I used to do that but not with how my eyes are currently.

http://www.butterflies-eyecare.co.uk/