Ophthalmic drugs, both diagnostic and therapeutic, play a central role in new developments in optometry, particularly as practitioners extend their involvement in primary care. Optometrists now dilate more patients in routine practice, and this brings increasing concern about the risk of provoking acute closed angle glaucoma (CAG) attacks. It would seem that the risk of inducing acute CAG is far outweighed by the potential benefit of examining the eye through a dilated pupil. Driving difficulties, reported subjectively to be the result of glare, are frequently encountered by patients after dilation, and advice from the College of Optometrists is welcomed. The local anaesthetic proxymetacaine 0.5% is now marketed in the UK in preservative-free unit-dose applicators both alone and in combination with fluorescein, and is a more comfortable alternative to existing anaesthetics in unit-dose form. The second half of this paper includes a summary of the background to recent developments, as the UK profession takes its first steps towards the use of ocular therapeutic agents. Finally, some exciting new therapeutic preparations for use in the treatment of glaucoma, allergic eye disease, and dry eye conditions are discussed.