|LETTER TO EDITOR
|Year : 1992 | Volume
| Issue : 3 | Page : 99
Colours for your eyes
Mohan Raj Nair
Ophthalmic Surgeon, C.B.M. Ophthalmic Institute, Angamally, India
Mohan Raj Nair
Ophthalmic Surgeon, C.B.M. Ophthalmic Institute, Angamally
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Nair MR. Colours for your eyes. Indian J Ophthalmol 1992;40:99
How often have patients come to us with a history of using some eye drops, prescribed either by an ophthalmologist or bought over the counter or even left over drops used previously by one of the family members. We are then faced with a dilemna as to whether any of the eye drops used are related to the present disease or has modified the disease process. Unfortunately most of the labels are in English with unfamiliar names, making it difficult for even the educated, to remember.
Can something be done? In a country with so many languages and a low literacy rate, it is obvious that using the most widely spoken language or the regional language on the package is impractical. Some other identification system has to be introduced which is simple, needs no literary sense and be fairly reliable. It is often seen that patients give information on the ocular drug used by refering them to the colour of the label. This I think, sets the basis for a simple identification system- Colour Coding.
What are the advantages if such a system can be implemented. We could with a fair amount of certainity know the previous medications, atleast the group of drugs the patient was on. It is thus helpful for instance to recognize a steroid induced rise of intra-ocular pressure or lens opacity, if the patient is on antiglaucoma medications or if the dilated pupil is iatrogenic. It also becomes simple to instruct the patient, literate or illiterate, on which ocular medications to be used when and how often. For example, it is easier for the patient to understand that the bottle with the green label is to be used four times and the one with the white label twice, rather than X drops to be used four times and Y twice. In addition it totally obviates the need for the pharmacist to scribble dosages on the package which invariably runs the risk of getting interchanged. However, we often notice that patients when they bring their medications, the box is lost and so with it the dosage schedule. Another big advantage is for the partially sighted. It becomes so much easier for them to understand and recognise their drug requirements if dosages and colour are related. Lastly, it becomes easy for the patient to comprehend changes in the dosage schedules during the course of the treatment.
On the otherhand, let us examine some of the disadvantages or objections which may arise. One major area, both for the clinician and the pharmaceutical company, is the abolition of combination medications.
Thought his marginally increases the cost of medication, it certainly is necessary to prevent abuse of drugs and keep the dosage options open. For example, the most common combination of antibiotic-steroid if given separately, offers more room for varying the dosage of each as the treatment progresses according to the response. In addition it reduces the indiscriminate use of steroids. Another objection may be raised when two of a group are required which have a similar colour code. Though it is highly unlikely that two of the same group are to be used except probably with antibiotics, one can switch between drops and ointment to clear any confusion. A valid protest may come from the pharmaceutical companies who have established their brand identification by introducing specific colour schemes on their presentation packs. To circumvent this problem, I would like to suggest that the top 1/3 of the pack follow the colour scheme with the lower 2/3 being left for brand identification. One drawback is in the identification of the drug if the patient develops allergy since the system only identifies the group. Another being for those colour blind.
The drugs have been divided into seven groups each with contrasting colour codes. The colours selected are those that can be easily related to our surroundings. The proposal is as follows:
Suggested Colour Code:
Brown - Antifungals.
Blue - Beta Blockers.
Green - Miotics
Red - Mydriatics
Black - Steroids
Yellow - Antibiotics.
White - All other Medications.
It is further proposed that the label on the bottle be fully of the given colour code so that in the event of the package being lost, the patient will still be able to follow the instructions. Strengths may be written as a bold number on the top flap to be noticed easily.
This coding system, I feel satisfies both the patients need to clearly understand a dosage schedule or identify a previous medication and the clinician's effort to explain in fair certainty so that there will be no misunderstanding. The author welcomes comments from the fraternity and the industry on this proposal.