Dry eye (xerophthalmia, dry eye disease)
Clinical basis & sources
- Primary source
- OCP Expanding Scope of Practice
Sources used
- Minor Ailments PrescribingOntario College of Pharmacists · 2026
- Expanding Scope of Practice - Minor AilmentsOntario College of Pharmacists · 2026-05-28
- Ontario Regulation 133/26: GeneralGovernment of Ontario · 2026-05-11
- Executive Officer Notice: Update to Funding for Minor Ailment Services in Ontario Pharmacies (Effective July 1, 2026)Government of Ontario · 2026-05-19
- Dry EyeNational Eye Institute · Accessed 2026-06-01
- Dry eyesNHS · Accessed 2026-06-01
- Minor Ailment Assessment: Dry EyePharmacy Association of Nova Scotia · 2025-11
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Allowable drugs under Schedule 4 (12)
Drugs an Ontario pharmacist may prescribe for Dry eye (xerophthalmia, dry eye disease) under O. Reg. 256/24, Schedule 4. Choice still depends on the assessment, contraindications, allergies, and product availability — this is the eligible list, not a recommendation.
- Carboxymethylcellulose
- Dextran 70
- Glycerin
- Hydroxypropyl guar
- Hypromellose (HPMC)
- Lanolin
- Mineral oil
- Petrolatum
- Polyethylene glycol 400
- Polyvinyl alcohol
- Povidone (polyvinylpyrrolidone)
- Propylene glycol
Symptoms this assessment screens
- Dryness, grittiness, burning, stinging, tired eyes, or foreign-body sensation consistent with dry eye
- No moderate/severe pain, light sensitivity, vision loss, halos, trauma, chemical exposure, or contact-lens red-eye concern
- Likely contributors reviewed such as dry air, screen use, medications, contact lenses, aging, or ocular surface history
- Contact lens use, preservative exposure, drop frequency, and ointment-related blur risk reviewed
- Pharmacist is selecting only Ontario Schedule 4 ophthalmic lubricant therapy, not anti-infective, steroid, allergy, or immunomodulatory therapy
Red flags — any positive means refer
- Moderate/severe eye pain, photophobia, decreased or changed vision, halos, corneal opacity, fixed pupil, severe headache, or nausea/vomiting with eye symptoms
- Chemical exposure, eye trauma, suspected foreign body, corneal abrasion, or sudden onset after injury
- Contact lens wearer with red eye, pain, discharge, photophobia, decreased vision, or inability to comfortably remove/use lenses
- Purulent discharge, eyelid/periorbital swelling, fever, vesicles, corneal ulcer concern, or unilateral marked redness
- Recent eye surgery, glaucoma or significant eye disease, autoimmune/Sjogren concern, recurrent severe dry eye, or failed lubricant trial
- Needs antibiotic, corticosteroid, cyclosporine, lifitegrast, allergy, glaucoma, or other non-lubricant eye therapy
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