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relating to use in pregnancy is more limited and therefore the effects of the drugs is less predictive in pregnancy. Use of these drugs in pregnancy stems from anecdotal experience.

Category 3 Drugs with positive evidence of human fetal risk. This does not automatically mean they cannot be used in pregnancy.

Table A7.1 should only be used in conjunction with up-to-date guides such as the British National Formulary, the National Teratology Information Service (Tel: +44(0)191 232 1525, www. nyrdtc.nhs.uk/Services/teratology/teratology.html ), and the Medicines Information Department at Moorfields Eye Hospital (Tel: +44(0)20 7566 2369).

Sources: National Teratology Information Service guidelines, British National Formulary, Medicines Information Department (Moorfields Eye Hospital).

We are most grateful to Miss Jill Bloom, Senior Pharmacist in the Medicines Information Department at Moorfields Eye Hospital, and to Dr Patricia McElhatton, Consultant Teratologist and head of the National Teratology Information Service.

7 Appendix

703

704

Ophthalmic drug use in pregnancy

Table A7.1: Drug use in pregnancy

Medication group

Category 1

Category 2A

Category 2B

Category 3

 

 

 

 

 

Lubricants

Hypromellose

 

 

 

 

Carbomers

 

 

 

 

Polyvinyl alcohol

 

 

 

 

Povidone

 

 

 

 

Simple eye

 

 

 

 

ointment/paraffins

 

 

 

 

Carmellose

 

 

 

 

Sodium chloride 0.9%

 

 

 

 

Hydroxyethylcellulose

 

 

 

Antibacterial

Fusidic acid

Chloramphenicol

Quinolones

Tetracycline group (s,

 

Vancomycin (s & t)

 

Aminoglycosides

2nd & 3rd trimester)

Antiinfectious

Penicillins (s & t)

 

(gentamicin, neomycin,

 

Cephalosporins (s & t)

 

framycetin, tobramycin)

 

Metronidazole (s)

 

Sulphonamides (s)

 

Erythromycin (s & t)

 

Trimethoprim (s & t)

 

Clindamycin (s)

 

Clarithromycin (s)

 

Azithromycin (s)

 

 

 

 

Polymyxin B

 

 

 

 

Tetracycline (s, 1st

 

 

 

 

trimester)

 

 

 

 

 

 

 

 

Medication group

Antiinfectious

Antifungal

Antiviral

 

 

Antiamoebic

Pressure lowering medications

Antiinflammatories

Antiallergic

Category 1

Category 2A

Category 2B

Category 3

Clotrimazole

Miconazole

Fluconazole (s)

 

Amphotericin

Econazole

 

 

 

Natamycin

 

 

Aciclovir (s & t)

 

Ganciclovir (ins & t)

 

Famciclovir (s)

 

Trifluorothymidine

 

Valaciclovir (s)

 

(trifluridine)

 

Polyhexanide/PHMB

Propamidine

 

 

Chlorhexidine

 

 

 

Beta blockers

Pilocarpine

Prostaglandin Fanalogues

 

 

α2 agonists

Glycerin (s)

 

 

α agonists

Mannitol (inj)

 

 

Carbonic anhydrase

 

 

 

inhibitors (s & t)

 

 

NSAIDs (s & t; in 1st &

Corticosteroids (s & t,

Rimexolone (very limited

NSAIDS (s & t; in 3rd

2nd trimester only except

except rimexolone)

data)

trimester)

for ketorolac)

Aspirin (s; low dose)

 

 

 

Ketorolac (s & t; in 1st

 

 

 

& 2nd trimester)

 

 

Mast cell stabilizers (s & t)

Antihistamines (s & t,

 

 

 

less data available)

 

 

 

 

 

(Continued on next page)

705

Appendix7

706

Ophthalmic drug use in pregnancy

Table A7.1: Drug use in pregnancy—cont’d

Medication group

Category 1

Category 2A

Category 2B

Category 3

Diagnostic

Fluorescein

Phenylephrine

 

 

 

Tropicamide (but see

Fluorescein (inj)

 

 

 

Misc.)

 

 

 

 

Cyclopentolate (but see

 

 

 

 

Misc.)

 

 

 

 

Rose Bengal

 

 

 

Miscellaneous

Lidocaine (inj & t)

Tropicamide

Verteporfin (inj)

Cyclophosphamide (s)

 

Paracetamol (s)

(multidosage)

Indocyanine green (inj)

Azathioprine (s)

 

Sodium citrate

Cyclopentolate

 

 

 

Ascorbate (s & t)

(multidosage)

 

 

 

Acetylcysteine

Atropine

 

 

 

Sodium chloride 5%

Homatropine

 

 

 

 

Hyoscine

 

 

 

 

Ciclosporin (s & t)

 

 

 

 

Mycophenolate (s)

 

 

 

 

Local anaesthetics

 

 

 

 

(except lidocaine)

 

 

 

 

Botulinum toxin (inj)

 

 

 

 

Povidone iodine

 

 

Where no abbreviation is used, this refers to the topical medication only.

Otherwise: s, systemic; t, topical; ins, intraocular insert; inj, injection; iv, intravenous.

Appendix 8

 

Reading Test Types

 

Held at 15 inches = 38 cm

 

N4.5

 

As we walked along the edge of the river, the mild breeze rustling the trees whose boughs were bent over the water by the

 

weight of their leaves, I could not help but recall those happy memories of childhood.

 

N5

 

with the actual experience of it all being quite overwhelming. I could not help but wonder who had been here

 

before me, what feet had tread the same marble tiles that I stood on now.

 

N6

 

What a difference a day makes. One day, you find yourself hard up, wandering where you are

 

going to get your next meal; the next day, just like a fairy-tale ending, a rich uncle claims you

 

to be his long-lost nephew.

 

N8

 

but it was the music lessons I looked forward to the most. That

 

one hour spent in the music room was my escape from all the

 

troubles around me. It just took a few bars on the piano for my spirits to

 

lift.

 

N9

 

There is nowhere that can compare to Paris in the springtime. It

 

is known as the most romantic city in the world and no wonder!

 

The blossoms on the trees, the cafes by the riverside

 

N10

 

yet the face in the photograph was strangely familiar – the

 

same arched brows, the same deep-set grey eyes, even

 

the same twist to the mouth in that familiar

 

N12

 

The little girl was playing on the swings with her

 

mother tenderly watching over her. Her elder

 

brother was amusing himself on the seesaw, all

 

the while trying to gain

707

Reading test types

N14

as the columns became broader, the room became narrower, so that by the time we reached the end of the walk

N18

The sand was a pearly white, much whiter than I had imagined it to be.

N24

great flocks of birds were heading south for

N36

over the rooftops

N48

elephant trunks

708

Appendix 9

Amsler Chart

Chart to be held at a comfortable reading distance (Fig. A9.1).

Fig. A9.1: Amsler chart. (Chart reproduced with kind permission of Keeler Ltd, Windsor, UK.)

709

Appendix 10

Contact Details

British Retinitis Pigmentosa

Medical Defence Union

Society

230 Blackfriars Road

Head Office

London SE1 8PJ

P.O.Box 350

Tel: 020 7202 1500

Buckingham MK18 1GZ

www.the-mdu.com

Tel: 01280 821334

 

www.brps.org.uk

 

Drivers Medical Group, DVLA

Medical Protection Society

Swansea SA99 1TU

33 Cavendish Square

Tel: 0870 600 0301 (8.15am to

London W1G 0PS

4.30pm Monday to Friday)

Tel: 0845 605 4000

www.dvla.gov.uk

www.medicalprotection.org

The Dystonia Society

Moorfields Eye Hospital

46/47 Britton St.

City Road

London

London EC1V 2PD

EC1M 5UJ

Tel: 020 7253 3411

Tel: 020 7490 5671

www.moorfields.nhs.uk

www.dystonia.org.uk

 

British Medical Association

National Institute for Clinical Excellence

BMA House

Mid City Place

Tavistock Square

71 High Holborn

London WC1H 9JP

London

Tel: 020 7387 4499

WC1V 6NA

www.bma.org.uk

Tel: 020 7067 5800

 

www.nice.org.uk

Fight for Sight

National Poison Information Service

Institute of Ophthalmology

(London Centre)

Bath Street

Guys and St. Thomas’ Hospital NHS Trust

London EC1V 9EL

Medical Toxicology Unit

Tel: 020 7608 4000

Avonley Road

www.fightforsight.org.uk

London SE14 5ER

 

Tel: 0870 600 6266

 

www.spib.axl.co.uk

General Medical Council

Royal College of Ophthalmologists

178 Great Portland Street

17 Cornwall Terrace

London W1W 5JE

London NW1 4QW

Tel: 020 7580 7642

Tel: 020 7935 0702

www.gmc-uk.org

www.rcophth.ac.uk

710

 

 

 

Appendix

Institute of Optometry

RNIB (Royal National Institute for the

 

Guidedogs for the Blind Association

Royal College of Surgeons (Edinburgh)

 

 

Burghfield Common

Nicolson Street

 

 

Reading RG7 3YG

Edinburgh EH8 9DW

 

 

Tel: 0870 600 2323

Tel: 0131 527 1600

 

 

www.guidedogs.org.uk

www.rcsed.ac.uk

 

 

56–62 Newington Causeway

Blind)

 

10

London SE1 6DS

105 Judd Street

 

 

 

Tel: 020 7407 4183

London WC1H 9NE

 

 

www.ioo.org.uk

Tel: 0845 330 3723

 

 

 

www.rnib.org.uk

 

 

Macular Disease Society

Vision 2020

 

 

PO Box 247

London School of Hygiene

 

 

Haywards Heath

and Tropical Medicine

 

 

West Sussex RH17 5FF

Keppel Street

 

 

Tel: 0990 143 573

London WC1E 7HT

 

 

www.maculardisease.org

Tel: 020 7927 2974/3

 

 

 

www.v2020.org

 

 

 

 

 

 

711

Index

 

A

Allergic conjunctivitis—cont’d

 

Abnormal retinal correspondence

drop toxicity (contact

 

 

583–4

hypersensitivity)

128–9

 

Abscess, lacrimal sac 68

vernal keratoconjunctivitis

 

AC/A ratio 596

124–7

 

 

 

 

Acanthamoeba keratitis 176–7

Alpha2-agonists 276

 

 

 

Accommodation disorders

Alphabet patterns

603–4

 

599–600

Altitudinal field defect

641, 654

 

Acetazolamide 277

Amaurosis fugax 634–6

 

 

Achromyces canaliculitis 65

Amblyopia 589–90

 

 

 

Acne rosacea 116

AMD see Age-related macular

 

Actinic keratosis 39

degeneration

 

 

 

Acute angle closure glaucoma

Amiodarone vortex keratopathy

 

325–7

200, 201

 

 

 

 

Acute anterior uveitis 333–6

AMPPE see Acute multifocal

 

Acute hypoxic epitheliopathy 210

posterior pigment

 

Acute multifocal posterior placoid

epitheliopathy

 

 

 

pigment epitheliopathy

Ampullectomy

60

 

 

 

 

(AMPPE) 358

Amsler chart

709

 

 

 

 

Acute retinal necrosis 367–8

Anaphylaxis 687

 

 

 

 

Acute zonal occult outer

Anecortave acetate 462

 

 

retinopathy 453

Angiography

 

 

 

 

 

Adenomatous intestinal polyposis

fluoroscein

415–23

 

 

 

399

indocyanin green 424

 

 

Adenoviral keratoconjunctivitis

Angioid streaks 449–51

 

 

119–21

Angiosarcoma

92

 

 

 

 

Adie’s pupil 632

Angle-closure glaucoma

325–7

 

Adult inclusion conjunctivitis

Angle recession 313

 

 

 

122–3

Aniridia 574

 

 

 

 

 

Advanced life support 684–6

Anisocoria 632–3

 

 

 

 

Age-related macular degeneration

Anisometropia 560

 

 

 

454–62

Ankyloblepharon 133

 

 

 

AIDS see HIV

Ankylosing spondylitis

334

 

AION 654–6

Anophthalmos 79–80

 

 

 

Albinism 509–10

Anterior capsule tears

266

 

Alcohol-tobacco amblyopia

Anterior segment dysgenesis

 

664–5

574–7

 

 

 

 

Allergic conjunctivitis 124–9

aniridia 574

 

 

 

 

acute, seasonal and perennial

Axenfeld’s anomaly

576

 

124

iridocorneal endothelial

 

atopic keratoconjunctivitis 127

syndrome

576–7

 

contact lens-associated

Peter’s anomaly

576

 

 

papillary conjunctivitis

posterior embryotoxon

576

 

712

127–8

posterior keratoconus

576