Hypromellose

How it works

It is a hydrophilic polymer that increases tear viscosity and forms a stable, moisture-retaining film over the ocular surface, prolonging lubrication of the cornea and conjunctiva.

Prescribing in practice

• Preserved multidose preparations can cause ocular surface toxicity or irritation with frequent or long-term use, so use a preservative-free product for chronic or frequent dosing or in sensitive patients.
• Effect is relatively short-lived so frequent instillation may be needed, and it may be used as often as required.
• Separate the instillation of different eye drops and apply ointments last when more than one product is used.

Monitoring

No systemic monitoring is required; review symptom control and ocular surface health at clinical follow-up.

Counselling the patient

• Brief blurring of vision is common after each drop, so wait until vision is clear before driving.
• Do not allow the dropper tip to touch the eye and discard the bottle within the period stated after opening.

Evidence & guidelines

Hypromellose is a long-established first-line artificial tear for dry eye disease in routine ophthalmic practice and NICE Clinical Knowledge Summaries.