Will pharmacists heed OTC eye drop advice?

The AOP has warned that in some cases pharmacists should consult a patient's optometrist before prescribing Chloramphenicol.
Specifically, the Association is concerned that chemists do not have the appropriate equipment, which is readily available in the optometry profession. 
Last week the Medicines and Healthcare products Regulatory Agency (MHRA) announced that Chloramphenicol eye drops could be safely sold through pharmacies for the treatment of acute bacterial conjunctivitis.
The move represents the first antibiotic eye treatment that can be accessed without a prescription in the UK, and highlights the Government's commitment to expand the range of medicines available for self-medication.
MHRA chief executive, Professor Kent Woods, said: 'The case for making this medicine available over the counter, both in terms of patient safety and the risk of emergent bacterial resistance, has been debated thoroughly.
'We are convinced that the potential health benefits outweigh any risks to patients, or to the community at large.'
However, AOP chief executive Bob Hughes said: 'The Association believes that pharmacists should prescribe Chloramphenicol only with caution and that they should never treat red eye, if the patient is a contact lens wearer, without the prior approval of an optometrist.
'While there are many benefits to be gained by patients from independent prescribing by pharmacists, the Association's particular concern is that, given the difficulty of accurately diagnosing many eye conditions without access to a slit-lamp microscope, the inadvertent treatment of a dendritic ulcer, for example with a steroid, could be potentially sight threatening.
'Similarly,' he warned, 'without access to a slit-lamp, microbial keratitis in a contact lens wearer may be mistaken for conjunctivitis with devastating consequences.'
The Royal Pharmaceutical Society of Great Britain has issued guidance on the eye drops which states that contact lens wearers should be referred to an optometrist, and that lenses should not be worn during treatment. But, speaking to optician, Hughes said: 'The guidelines look OK on paper but will it work like that in practice?'
The reclassification of Chloramphenicol eye drops was subject to a public consultation exercise. In its response, the AOP warned that optical equipment was essential to diagnose ocular health. Trevor Warburton, chairman of the AOP's professional services committee, wrote to the MHRA at the end of last month.
'Our particular concern is that it is difficult or impossible to accurately diagnose many eye conditions without access to a slit-lamp microscope and the skill to use it,' he wrote.
However, despite these concerns, a spokesman for the Royal Pharmaceutical Society of Great Britain said it was a step forward. David Pruce, the Society's director of practice and quality improvement, said: 'Making Chloramphenicol eye drops available without a prescription is a safe, effective and convenient route to treatment for the many patients who visit pharmacies every day with acute bacterial conjunctivitis.'