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Eye conditions

About

What is covered

This interactive flowchart covers eye conditions, including macular conditions, corneal damage, cataracts, refractive errors, double vision, nystagmus and thyroid eye disease, and a link to NICE's recommendations on glaucoma.
To find other information about eye conditions, including evidence from NICE accredited sources, visit NICE Evidence Search.

Updates

Updates to this interactive flowchart

31 October 2017 Aflibercept for treating choroidal neovascularisation (NICE technology appraisal guidance 486) added to uveal tract conditions.
15 August 2017 Holoclar for treating limbal stem cell deficiency after eye burns (NICE technology appraisal guidance 467) added to front of the eye conditions.
25 July 2017 Adalimumab and dexamethasone for treating non-infectious uveitis (NICE technology appraisal guidance 460) added to uveal tract conditions.
27 September 2016 Miniature lens system implantation for advanced age-related macular degeneration (NICE interventional procedures guidance 565) added to age-related macular degeneration, and aflibercept for treating visual impairment caused by macular oedema in branch retinal vein occlusion (NICE technology appraisal guidance 409) added to macular oedema (retinal vein occlusion).
15 December 2015 Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears (NICE technology appraisal guidance 369) added to conditions of the eye socket and tear system and insertion of a subretinal prosthesis system for retinitis pigmentosa (NICE interventional procedures guidance 537) added to retinitis pigmentosa.
24 November 2015 Implantation of a corneal graft–keratoprosthesis for severe corneal opacity in wet blinking eyes (NICE interventional procedures guidance 534) added to front of the eye conditions.
2 June 2015 Insertion of an epiretinal prosthesis for retinitis pigmentosa (NICE interventional procedures guidance 519) added to retinitis pigmentosa.
25 February 2014 Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion (NICE technology appraisal guidance 305) added to macular oedema retinal vein occlusion.

Person-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Your responsibility

Guidelines

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Technology appraisals

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this interactive flowchart is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the recommendations to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Medical technologies guidance, diagnostics guidance and interventional procedures guidance

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account. However, the interactive flowchart does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the recommendations, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Short Text

Everything NICE has said on eye conditions in an interactive flowchart

What is covered

This interactive flowchart covers eye conditions, including macular conditions, corneal damage, cataracts, refractive errors, double vision, nystagmus and thyroid eye disease, and a link to NICE's recommendations on glaucoma.
To find other information about eye conditions, including evidence from NICE accredited sources, visit NICE Evidence Search.

Updates

Updates to this interactive flowchart

31 October 2017 Aflibercept for treating choroidal neovascularisation (NICE technology appraisal guidance 486) added to uveal tract conditions.
15 August 2017 Holoclar for treating limbal stem cell deficiency after eye burns (NICE technology appraisal guidance 467) added to front of the eye conditions.
25 July 2017 Adalimumab and dexamethasone for treating non-infectious uveitis (NICE technology appraisal guidance 460) added to uveal tract conditions.
27 September 2016 Miniature lens system implantation for advanced age-related macular degeneration (NICE interventional procedures guidance 565) added to age-related macular degeneration, and aflibercept for treating visual impairment caused by macular oedema in branch retinal vein occlusion (NICE technology appraisal guidance 409) added to macular oedema (retinal vein occlusion).
15 December 2015 Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears (NICE technology appraisal guidance 369) added to conditions of the eye socket and tear system and insertion of a subretinal prosthesis system for retinitis pigmentosa (NICE interventional procedures guidance 537) added to retinitis pigmentosa.
24 November 2015 Implantation of a corneal graft–keratoprosthesis for severe corneal opacity in wet blinking eyes (NICE interventional procedures guidance 534) added to front of the eye conditions.
2 June 2015 Insertion of an epiretinal prosthesis for retinitis pigmentosa (NICE interventional procedures guidance 519) added to retinitis pigmentosa.
25 February 2014 Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion (NICE technology appraisal guidance 305) added to macular oedema retinal vein occlusion.

Sources

NICE guidance and other sources used to create this interactive flowchart.
Aflibercept for treating choroidal neovascularisation (2017) NICE technology appraisal guidance 486
Holoclar for treating limbal stem cell deficiency after eye burns (2017) NICE technology appraisal guidance 467
Adalimumab and dexamethasone for treating non-infectious uveitis (2017) NICE technology appraisal guidance 460
Ocriplasmin for treating vitreomacular traction (2013) NICE technology appraisal guidance 297
Insertion of a subretinal prosthesis system for retinitis pigmentosa (2015) NICE interventional procedures guidance 537
Insertion of an epiretinal prosthesis for retinitis pigmentosa (2015) NICE interventional procedures guidance 519
Corneal inlay implantation for correction of presbyopia (2013) NICE interventional procedures guidance 455
Epiretinal brachytherapy for wet age related macular degeneration (2011) NICE interventional procedures guidance 415
Phototherapeutic laser keratectomy for corneal surface irregularities (2010) NICE interventional procedures guidance 358
Limited macular translocation for wet age-related macular degeneration (2010) NICE interventional procedures guidance 339
Arteriovenous crossing sheathotomy for branch retinal vein occlusion (2010) NICE interventional procedures guidance 334
Corneal endothelial transplantation (2009) NICE interventional procedures guidance 304
Implantation of an opaque intraocular lens for intractable double vision (2009) NICE interventional procedures guidance 293
Corneal implants for keratoconus (2007) NICE interventional procedures guidance 227
Corneal implants for the correction of refractive error (2007) NICE interventional procedures guidance 225
Photorefractive (laser) surgery for the correction of refractive error (2006) NICE interventional procedures guidance 164
Retrobulbar irradiation for thyroid eye disease (2005) NICE interventional procedures guidance 148
Endoscopic dacryocystorhinostomy (2005) NICE interventional procedures guidance 113
Scleral expansion surgery for presbyopia (2004) NICE interventional procedures guidance 70
Insertion of hydrogel keratoprosthesis (2004) NICE interventional procedures guidance 69
Transpupillary thermotherapy for age-related macular degeneration (2004) NICE interventional procedures guidance 58
Radiotherapy for age-related macular degeneration (2004) NICE interventional procedures guidance 49
Boston Keratoprosthesis Type I for corneal blindness (2017) NICE medtech innovation briefing 91
TearLab osmolarity system for diagnosing dry eye disease (2015) NICE medtech innovation briefing 47

Quality standards

Quality statements

Effective interventions library

Effective interventions library

Successful effective interventions library details

Implementation

NICE has produced resources to help implement its guidance on:

Information for the public

NICE has written information for the public on each of the following topics.

Pathway information

Person-centred care

People have the right to be involved in discussions and make informed decisions about their care, as described in your care.
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

Your responsibility

Guidelines

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Technology appraisals

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take these recommendations fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this interactive flowchart is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the recommendations to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Medical technologies guidance, diagnostics guidance and interventional procedures guidance

The recommendations in this interactive flowchart represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take these recommendations fully into account. However, the interactive flowchart does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the recommendations, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this interactive flowchart should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

Supporting information

Why we made the recommendations on aflibercept for treating choroidal neovascularisation

Ranibizumab is already recommended by NICE for treating choroidal neovascularisation. An indirect comparison of aflibercept and ranibizumab shows that both drugs provide similar overall health benefits. The total costs of aflibercept are the same as or less than those of ranibizumab.
Because it has similar costs and overall health benefits to ranibizumab, aflibercept is also recommended as a cost-effective option for treating choroidal neovascularisation.
For more information see the committee discussion in the NICE technology appraisal guidance on aflibercept for treating choroidal neovascularisation.

Glossary

Paths in this pathway

Pathway created: November 2013 Last updated: October 2017

© NICE 2017. All rights reserved. Subject to Notice of rights.

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