Current advice is that, when the supply of Bausch & Lomb Fluorets runs out later this summer, optometrists, contact lens opticians and dispensing opticians should use 1% minims for diagnosis, contact lens fitting and tear film work in accordance with the College of Optometrists guidelines.
However many practitioners have concerns about this, highlighting that fluorescein sodium solution is more difficult to deliver to the surface of the eye in appropriate quantities from a minim. Like strips, minims are also licensed as single-use products which means they can only be used on one patient at a given point in time then have to be discarded. Reusing minims on more than one patient raises a serious risk of cross-infection and increased risk of pseudomonas keratitis. In view of both these issues, practitioners have a clear preference for the use of alternative CE-marked single-use impregnated paper strips however it is unclear whether such strips can legally be used by community practitioners.
To help clarify the position with regard to CE-marked strips, the Optical Confederation is convening a panel of academics and experienced clinicians to develop a consensus ‘peer view’ on these issues. The panel will take account of all available information, their own clinical experience and knowledge and seek to reach a consensus view on what to do and not do in the circumstances, including a view on the use of alternative fluorescein products. It is envisaged that this work will take about three weeks to complete and the consensus opinion should be available towards the end of July. The Optical Confederation, the College of Optometrists, the General Optical Council and BCLA are arranging a round table meeting to discuss concerns about the use of minims. In the meantime, if Optical Confederation members are running short of supplies of Fluorets and have doubts about what to do in particular cases, they should contact their Optical Confederation representative body for advice:
● Elaine Grisdale (email@example.com) for ABDO members
● Geoff Roberson (firstname.lastname@example.org) for AOP members
● Mark Nevin (email@example.com) for FODO members
● Simon Rodwell (firstname.lastname@example.org) for ACLM members
● Malcolm Polley (email@example.com)for FMO members.
The Optical Confederation is also working closely with colleagues in ECOO and the Republic of Ireland to seek to resolve this.