a Cessation of lens wear and use of sodium cromoglicate
eye drops until resolution
Most eye drops contain the compound sodium cromoglicate
and well-known brands includeOpticromandOptrex.
This involves the use of mast cell stabilisers eg, sodium cromoglicate
. (47,50,62) Approximately 75% of patients with moderate to severe CLGPC who do not respond to standard treatment can continue with contact lens wear after treatment with 2% or 4% sodium cromolyn following a period of lens wear cessation.
Also Moorields pharmacy has introduced Catacrom, a preservative-free sodium cromoglicate
, a mast cell stabiliser to treat hayfever compatible with contact lens wear
As noted in the previous article (OT, November 12 2010), the ideal management of CLPC involves discontinuation of contact lens wear followed by a four-times-daily (QDS) regimen of a mast cell stabilizer such as sodium cromoglicate. (13-16) The logic of such a treatment might be questioned since sodium cromoglicate is not considered to have any constitutive anti-inflammatory activity; the removal of the stimulus to inflammation should help and better results might be obtained with other mast cell stabilisers/anti-eosinophil drugs such as lodoxamide or nedocromil sodium (both available to AS optometrists).
(32,34) Good eyelid margin hygiene should also reduce the recurrence of the condition, but recurrent and stubborn inflammatory episodes may also need topical corticosteroid treatment (eg, prednisolone 0.5% QDS for a few days) to generally quieten the eye, reduce lacrimation and photophobia as well as reduce further development of corneal infiltrates (27,30,35) As an inflammatory condition, some limbitis cases may respond to topical mast cell stabilizers (eg, regular use of sodium cromoglicate over one month).
For chronic and recurrent allergic conjunctivitis, part of an appropriate management approach is the use of 'mast cell stabilisers', (21) with several drugs marketed in the UK (eg, sodium cromoglicate, lodoxamide and nedocromil sodium).
Sodium cromoglicate eye drops are widely available as P-medicines and even as a GSL product (see Table 1).
The commoner indications for the use of sodium cromoglicate eye drops are for chronic conditions such as SAC and PAC.