Background and Aims The use of ocular drugs in paediatrics is often “off-label”, concerning both safety in relation to the age and efficacy. For this reason we have deemed it necessary to examine prescribing habits of family paediatricians (pdf).

Methods Each pdf of Pordenone province (315.323 inhabitans) was sent a questionnaire where it was requested to list the ocular drugs usually prescribed, why they were prescribed and any side effect observed. They were also requested to confirm any use of dietary supplements or other medical devices.

Results All 35 pdf (34.440 chidren, aged 0–14 years) filled in the questionnaire. The most commonly prescribed drugs were antibiotics, anti-histamine agents and mast cell stabilizers for bacterial and allergic conjunctivitis. Only topical drugs were used. Children affected by serious ocular diseases were referred to ophtalmologists and of these only four assumed drugs for vernal keratoconjunctivitis and glaucoma (cyclosporine, timolol, dorzolamide and bimatoprost). Only minor adverse reactions (conjunctival hyperaemia, lid swelling) were found, even if potentially dangerous drug associations are still used (i.e. associations with steroids and/or sympathomimetic decongestants). No dietary supplements or medical devices were prescribed.

Conclusions Many ocular drugs lack reliable proof of efficacy and safety in paediatrics but fortunately their use outside the hospital seems limited. Nevertheless their use can probably be improved. Our research confirms the need to widen clinical studies of ocular drugs in paediatrics, not only concerning limited controlled trials but also their rational use.