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Clinical Guidance

Ophthalmic Safety Alert- Do not use apraclonidine in infants below six months of age

Feb 21

The College has recently received a report from NHS Improvement of a severe adverse reaction in a six month old child with anisocoria who had been administered apraclonidine 1% to help exclude Horner syndrome.  Two drops of apraclonidine 1% were administered to each eye, 30 minutes apart.  Ninety minutes later the child had an acute

  • 21 February 2019

How to protect patients and NHS staff against influenza infection

Sep 13

Flu immunisation remains the most effective method to help protect against influenza infection. Along with other interventions, influenza immunisation is an important tool in preventing and controlling respiratory infections in healthcare settings. Public Health England estimates that an average 8,000 people die from flu in England each year. Some years that figure reaches 14,000. That’s

  • 13 September 2018

Ophthalmic Safety Alert – Diabetic control and safe cataract surgery

May 01

The College has received queries from members to clarify whether there is a specific cut off for glycaemic control, either measured via HbA1C or a blood glucose level on the day, beyond which it is unsafe to proceed with cataract surgery. There is anecdotal evidence of cataract surgery cases being cancelled for surgery if their

  • 1 May 2018

Ophthalmic Safety Alert – intracameral cefuroxime

May 01

There are a range of cefuroxime preparations currently in use for the prevention of endophthalmitis in intraocular surgery. There are two licensed versions, Aprokam (Thea Pharmaceuticals) and  Ximaract (from Bausch & Lomb), both available as a  50mg powder and diluent solution for injection.  Also used are unlicensed prefilled syringes, of which some are compliant with

  • 1 May 2018

Ophthalmic Safety Alert – detachment of cannulas during ophthalmic surgery

Apr 17

The NHS Improvement national patient safety team have informed the College of the continued trend of incidents involving issues with detachment of cannulas during ophthalmic surgery (cannula-associated ocular injury, COI). The cannula is usually attached to either a saline or a viscoelastic syringe. The combination of a small lumen and plunger pressure can result in

  • 17 April 2018