66. BBC news. Bionic eye improves macular degeneration patient’s sight, July 2015. Accessed at http://www.bbc.co.uk/news/health-33612558 [on 25.11.15].

67. British Medical Association \& Royal Pharmaceutical Society of Great Britain. British National Formulary 70th edition, 2015.

68. National Institute for Health and Care Excellence. Technology appraisal 346: Aflibercept for treating diabetic macular oedema, 2015. Accessed at https://www.nice.org.uk/guidance/ta346 [on 25.11.15].

Reference 2 is no longer required

\subsection{P 99 -- Exercise 5 review (b)}
For clarity the following has been added ‘All people over 60 years of age are entitled to free sight tests.’

\subsection{Exercise 6 review}
In addition, a pharmacist should check when a patient’s condition was last monitored by a specialist and refer to monitoring intervals (at least every 12 months for glaucoma, at least every two years for ocular hypertension etc.).

\subsection{P 100 -- Case study 4 review (d)}
A useful website summarising the supplements similar in formulation to that used in AREDS 2 is http://www.areds2.org.uk/supplements. This site not only compares ingredients but lists total monthly costs.

The website ‘http://www.maculardisease.org/page.asp?section=189§ionTitle=Information+Sheets’ at the end of this section is no longer active and has been replaced with The National Eye Institute’s summary of results from the Age-Related Eye Disease Study, found at https://nei.nih.gov/amd.

\section{Section 5: Drug and disease related eye problems}

\subsection{P 102 -- Introduction}
The text states that ‘a topical steroid may be necessary post-operatively to reduce inflammation.’ The use of topical steroids post-operatively should be short-term, i.e. 1 month to 6 weeks is normal. This is less likely to give rise to steroid-induced side-effects. Pharmacists should query prolonged use of topical corticosteroids to ensure use is appropriately monitored.

\subsection{P 103 -- P 106 -- Drug-induced eye problems}
\subsubsection{Amiodarone}
In comparison to amiodarone, dronedarone has not been reported to cause ocular side-effects (http://www.ncbi.nlm.nih.gov/pubmed/12919771).

\subsubsection{Antimuscarinics}
Furthermore, oxybutynin is another example of an older antimuscarinic treatment. Oxybutynin is more likely (very common) to cause side-effects than solifenacin (common).

\subsubsection{Antiparkinsonian agents}
Levodopa is contra-indicated in patients with occludable angles. Levodopa can cause both miosis and mydriasis. There has only been one report of glaucoma with a multi-constituent product of levodopa in 52 years. There have been a few reports of blurred vision (5), visual impairment (9), diplopia (2), and miosis (2) from 1963 to 2015 (https://www.medicinescomplete.com).

Levodopa can cause oculogyric crisis. The BNF states that side-effects of levodopa include nausea and vomiting; rare side-effects include abdominal pain, blurred vision, blepharospasm, diplopia, activation of Horner’s syndrome, pupil dilatation, oculogyric crisis, flushing; and very rarely angle-closure glaucoma (http://www.evidence.nhs.uk/formulary/bnf/current).

The SPC for procyclidine states that it is contra-indicated in individuals with known hypersensitivity to any component of the preparation, untreated urinary retention, closed angle glaucoma and gastro-intestinal obstruction (http://www.medicines.org.uk/EMC/medicine/2171/SPC/Kemadrin+Tablets+5+mg/).

The BNF now states that antimuscarinics should be used with caution in gastro-oesophageal reflux disease, diarrhoea, ulcerative colitis, autonomic neuropathy, acute myocardial infarction, hypertension, conditions characterised by tachycardia (including hyperthyroidism, cardiac insufficiency, cardiac surgery), pyrexia and in individuals susceptible to angle-closure glaucoma. They should also be used with caution in Down’s syndrome, in children and in the elderly.