netFormulary Dorset NHS
The Dorset Formulary has been developed in associations with
NHS Dorset Clinical Commissioning Group
Dorset County Hospital NHS Foundation Trust
Dorset Healthcare University NHS Foundation Trust
Poole Hospital NHS Foundation Trust
Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust
 
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 Formulary Chapter 11: Eye - Full Chapter
Notes:

Chapter review date:

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 Details...
11.01  Administration of drugs to the eye
11.02  Control of microbial contamination
11.03  Anti-infective eye preparations
11.03.01  Antibacterials
 note  Treatment of minor eye infections in primary care should be restricted to chloramphenicol +/- Fucithalmic®. If not resolving after 48 hours contact Acute Referral Clinic (GP line: 01202 726039)
For all infected eyes: if patient is experiencing +/- visual disturbances refer the same day
Chloramphenicol drops 0.5%
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First Choice
Green
 
Chloramphenicol ointment 1%
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First Choice
Green
 
Minims®Chloramphenicol drops 0.5%
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First Choice
Green
Preservative free 
Fusidic Acid m/r drops 1%
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Second Choice
Green
 
   
Ofloxacin drops 0.3%
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Formulary
Amber
DCHFT: Consultant use only. 
   
Propamidine Isetionate drops 0.1% (Brolene®)
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Formulary
Amber

Acanthamoeba keratitis (unlicensed indication)



DCHFT: Consultant use only. Not routinely stocked.

 
   
Ciprofloxacin ointment 0.3%
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Formulary
Amber
DCHFT: Consultant use only.
 
   
Dibrompropamidine Isetionate ointment 0.15% (Brolene®)
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Formulary
Amber
Acanthamoeba keratitis (unlicensed indication)

DCHFT: Consultant use only. Not routinely stocked. 
   
Gentamicin drops 0.3%
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Formulary
Amber
 
   
Levofloxacin 5mg/ml Eye Drops
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Formulary
Amber

Unit dose vials are preservative-free. Preserved formulations contain benzalkonium chloride 0.05 mg in 1 ml

RBCH only: Acute microbial keratitis and corneal conditions where benzlkonium chloride is contra-indicated. Where avoidance of preservative is not necessary (e.g. in patients without pre-existing corneal epitheliopathy or small corneal ulcers [<1mm]) preserved G.ofloxacin / G.levofloxacin will be the agent of choice.

For patients who might require treatment up to 6 months. Hospital consultant should advise GP of course length and stopping date. 

 
   
Moxifloxacin 0.5% Eye Drops
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Formulary
Amber

Contans boric acid as a preservative

RBCH only: Acute microbial keratitis and corneal conditions where benzlkonium chloride is contra-indicated. Based on clinical review of eye this may be more cost effective than preservative free G.levofloxacin. Boric acid is less toxic to the cornea than benzalkonium chloride, and is more suitable for short- to medium-term use.

For patients who might require treatment up to 6 months. Hospital consultant should advise GP of course length and stopping date.

 
   
Azithromycin dihydrate drops 1.5%
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Formulary
Red
 
   
Benzylpenicillin intravitreal injection
 Track Changes
Formulary
Red
unlicensedUnlicensed

DCHFT: Not routinely stocked. 
   
Ceftazidime 5% drops
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Formulary
Red
Preservative-free
unlicensedunlicensed

Not DCHFT. 
   
Cefuroxime drops 5%
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Formulary
Red
Preservative-free
unlicensedunlicensed

RBCH: Store in freezer until required for use.
DCHFT: Consultant use only. Unlicensed cefuroxime 5% kits available. Unlicensed frozen storage product not routinely stocked. 
   
Chlorhexidine Digluconate 0.03% drops
 Track Changes
Formulary
Red
unlicensedUnlicensed

Not DCHFT. 
   
Gentamicin drops 1.5%
View childrens BNF  Track Changes
Formulary
Red
Preservative free
unlicensedunlicensed: Available as a manufactured special

DCHFT: Both preservative free and with preservative available. 
   
Polihexanide Eye Drops
 Track Changes
Formulary
Red
unlicensedUnlicensed
Preservative free

RBCH: 0.02%

Not DCHFT. 
   
Amikacin Intravitreal injection
 Track Changes
Formulary
Red
unlicensedUnlicensed

DCHFT: Not routinely stocked. 
   
Vancomycin for Intravitreal Injection
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Formulary
Red
unlicensedUnlicensed

DCHFT: Not routinely stocked. 
   
11.03.02  Antifungals to top
 note  Many different fungi are capable of producing ocular infection. They may be identified by appropriate laboratory procedures. They are not commercially available - contact hospital pharmacy for information.
Amphotericin drops 0.15%
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Formulary
Red
Preservative free
unlicensedunlicensed

DCHFT: On formulary but not stocked. 
   
Miconazole drops 1%
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Formulary
Red
Preservative free
unlicensedunlicensed

DCHFT: On formulary but not stocked. 
   
Clotrimazole drops 1%
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Formulary
Red
Preservative free
unlicensedunlicensed
Not RBCH
DCHFT: On formulary but not stocked. 
   
Econazole drops 1%
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Formulary
Red
Preservative free
unlicensedunlicensed
Not RBCH
DCHFT: On formulary but not stocked. 
   
Natamycin drops 5%
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Formulary
Red

unlicensedunlicensed


DCHFT: On formulary but not stocked.

 
   
11.03.03  Antivirals
Aciclovir eye ointment 3%
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Formulary
Amber
Consider oral aciclovir as an alternative to aciclovir eye ointment as systemic therapy is less toxic to the cornea and affords adequate concentration into the cornea. 
   
Ganciclovir gel 0.15%
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Formulary
Red
Consultant only
In patients intolerant of aciclovir. 
   
Ganciclovir intravitreal injection
 Track Changes
Formulary
Red
unlicensedunlicensed

DCHFT: Not routinely stocked. 
   
Foscarnet intravitreal injection
 Track Changes
Formulary
Red
unlicensedUnlicensed

DCHFT: Not routinely stocked. 
   
11.04  Corticosteroids and other anti-inflammatory preparations
11.04.01  Corticosteroids
Dexamethasone drops 0.1% (Maxidex®)
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Formulary
Amber
 
   
Minims®Dexamethasone drops 0.1%
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Formulary
Amber
Preservative free 
   
Minims®Prednisolone drops 0.5%
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Formulary
Amber
Preservative free 
   
Prednisolone drops 0.5% (Predsol®)
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Formulary
Amber
 
   
Prednisolone drops 1% (Predforte®)
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Formulary
Amber
 
   
Prednisolone drops 0.1%
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Formulary
Amber
Preservative free
unlicensedunlicensed
Not RBCH

DCHFT: Both preservative free and 'with' preservative available. 
   
Betamethasone drops 0.1%
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Formulary
Amber
 
   
Betamethasone ointment 0.1%
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Formulary
Amber
 
   
Fluorometholone (FML®)
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Formulary
Amber
 
   
Maxitrol®
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Formulary
Amber
Eye drops, dexamethasone 0.1%, neomycin sulfate 3500 units /g, polymyxin B sulfate 6000 units/mL

Eye ointment, dexamethasone 0.1%, neomycin sulfate 3500 units/g, polymyxin B sulfate 6000 units/g 
   
Sofradex®
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Formulary
Amber
Dexamethasone (as sodium metasulphobenzoate) 0.05%, framycetin sulfate 0.5%, gramicidin 0.005%

Not at RBCH 
   
Betamethasone drops 0.1% with Neomycin 0.5%  (Betnesol N®)
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Formulary
Amber
Not DCHFT. 
   
Dexamethasone for ocular injection
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Formulary
Red
Not DCHFT. 
   
Loteprednol
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Formulary
Red
Not at DCHFT. 
   
Dexamethasone intravitreal implant (Ozurdex®)
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Formulary
Red
High Cost Medicine
CCG

Commissioned by CCG for use in accordance with NICE TA229, TA 349 and TA460.

 
Link  Commissioning statement for Dexamethasone intravitreal impant for diabetic macular oedema
Link  Commissioning Statement on the use of adalimumab and dexamethasone implant for non-infective uveitis
Link  NICE TA 349 Dexamethasone intravitreal implant for treating diabetic macular oedema
Link  NICE TA229: Dexamethasone intravitreal implant for the treatment of macular oedema secondary to retinal vein occlusion
Link  NICE TA460 Adalimumab and dexamethasone for treating non-infectious uveitis
   
Fluocinolone acetonide intravitreal implant (Iluvien®)
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Formulary
Red
High Cost Medicine
PbR excluded: Commissioned by CCG - Use in accordance with NICE TA301 
Link  Commissioning statement fluocinolone intravitreal implant
Link  NICE TA301: Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular oedema after an inadequate response to prior therapy (rapid review of technology appraisal guidance 271)
   
11.04.01  Intravitreal corticosteroids
11.04.02  Other anti-inflammatory preparations to top
Antazoline 0.5% with Xylometazoline 0.05% (Otrivine-Antistin®)
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First Choice
Green
First choice for
  • Seasonal allergies

  • Short term allergies
  •  
    Sodium Cromoglicate drops 2%
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    First Choice
    Green
    First choice for
  • Seasonal allergies

  • Long term allergies
  •  
    Lodoxamide drops 0.1%
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    Second Choice
    Green
    Second choice for
  • Adults

  • Seasonal allergies

  • Not at DCHFT. 
       
    Olopatadine drops 1mg/ml
    View adult BNF View SPC online View childrens BNF  Track Changes
    Second Choice
    Green
    Children
    Antihistamine and mast cell stabiliser combined and has advantage of twice daily application
    Second choice for
  • Adults

  • Seasonal allergies
  •  
       
    Adalimumab (Humira®)
    (Ophthalmology)
    View adult BNF View SPC online  Track Changes
    Restricted Drug Restricted
    Red
    High Cost Medicine
    NHS England
    BlueTeq

    Restricted Item Commissioned by NHS England for non-infectious uveitis in line with NICE TA460 at specialist centres only.

    Specialist centres in the South region:

    • University Hospital Southampton NHS Foundation Trust
    • Oxford University Hospitals NHS Foundation Trust
    • University Hospital Bristol NHS Foundation Trust

     
       
    11.05  Mydriatics and cycloplegics
    11.05  Antimuscarinics
    Atropine Sulfate drops 1%
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    Formulary
    Amber
    DCHFT: unlicensedUnlicensed 1% eye ointment also on local formulary. 
       
    Cyclopentolate Hydrochloride drops 0.5%
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    Formulary
    Amber
    Not RBCH 
       
    Cyclopentolate Hydrochloride drops 1%
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    Formulary
    Amber
     
       
    Minims® Atropine Sulfate drops 1%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative-free 
       
    Minims® Cyclopentolate Hydrochloride drops 1%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative-free 
       
    Minims® Tropicamide drops 0.5%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative-free 
       
    Minims® Tropicamide drops 1%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative-free 
       
    Minims® Cyclopentolate Hydrochloride drops 0.5%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Red
    Preservative-free

    RBCH only: For in-patient/clinic use.
    DCHFT: On local formulary and stocked. 
       
    11.05  Sympathomimetics
    Minims® Phenylephrine Hydrochloride drops 10%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Red
    Preservative-free 
       
    Minims® Phenylephrine Hydrochloride drops 2.5%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Red
    Preservative-free 
       
    Mydricaine No. 2 injection
     Track Changes
    Unlicensed Drug Unlicensed
    Red
    Compound preparation containing procaine, atropine and adrenaline.

    Unlicensed special.

    DCHFT: Consultant only. 
       
    11.06  Treatment of glaucoma
    11.06  Beta-blockers to top
    Betaxolol (Betoptic®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    Drops 0.25% and 0.5% 
       
    Betaxolol Unit dose eye drop suspension 0.25% (Betoptic®)
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    Formulary
    Amber
    Preservative-free.

    DCHFT: Not routinely stocked. 
       
    Brinzolamide 10mg / Brimonidine 2mg Eye Drops (Simbrinza®)
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    Formulary
    Amber
    For recommendation by Glaucoma specialists only as a precursor or to avoid a Trabeculectomy. 
       
    Levobunolol drops 0.5% and polyvinyl alcohol 1.4% (Betagan®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
     
       
    Timolol
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    Drops 0.25% and 0.5% 
       
    Timolol Once-daily (Timoptol®-LA)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    Gel forming solution 0.25% and 0.5%.

    Not DCHFT. Tiopex® 0.1% on local formulary. 
       
    Timolol Unit Dose Eye Drops
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    Preservative free
    Drops 0.25% and 0.5% 
       
    11.06  Prostaglandin analogues
    Latanoprost drops 50micrograms/ml
    View adult BNF View SPC online View childrens BNF  Track Changes
    First Choice
    Green
     
    Travoprost drops 40micrograms/ml (Travatan®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Green
     
       
    Bimatoprost drops 0.01% (Lumigan®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Green

    0.01% is only strength on formulary

     
       
    Latanoprost drops 50micrograms with timolol 5mg/ml  (Xalacom®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
     
       
    Travoprost drops 40micrograms/ml with timolol 5mg/ml (DuoTrav®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Green
    DCHFT: Not routinely stocked. 
       
    Latanoprost 50micrograms/ml Single Use Drops (Monopost®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative-free.

    RBCH: 1st line prostaglandin analogue for patients with preservative allergy.

    DCHFT: Consultant use only. 1st line prostaglandin analogue for patients with proven intolerance to preserved eye drops. 
       
    Tafluprost drops 15micrograms/ml (Saflutan®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Amber
    Preservative free.

    DCHFT: Consultant use only. 2nd line in patients with proven intolerance to preserved eye drops. 
       
    Bimatoprost drops 300micrograms/ml with timolol 5mg/ml (Ganfort®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Amber
    Includes preservative-free option where appropriate.

    DCHFT: Preservative free option - Consultant only and in patients with proven intolerance to preserved eye drops. 
    Link  Position on preservative-free eye drops
       
    Tafluprost 15micrograms/mL + Timolol 5mg/mL preservative free eye drops (Taptiqom®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    For patients who are unable to tolerate or are contraindicated for Ganfort® and where a preservative free formulation is truly required. 
    Link  Position statement on preservative-free eye drops
       
    11.06  Sympathomimetics
    Brimonidine tartrate drops 0.2%
    View adult BNF View SPC online  Track Changes
    Formulary
    Green
     
       
    11.06  Carbonic anhydrase inhibitors and systemic drugs
    Acetazolamide (Diamox®)
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    Formulary
    Amber
    Tablets 250mg
     
       
    Acetazolamide (Diamox® SR)
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    Formulary
    Amber
    Capsules 250mg
     
       
    Brinzolamide drops 10mg/ml (Azopt®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
     
       
    Dorzolomide drops 2% (Trusopt®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
     
       
    Dorzolomide unit dose drops 2% (Trusopt®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative free 
       
    Dorzolomide 2% with timolol 0.5% (Cosopt®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative free unit dose drops also amber 
       
    Brinzolamide drops 10mg with timolol 5mg/ml (Azarga®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Amber
    Consultant ophthalmologist 
       
    Acetazolamide injection 500mg
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Red
     
       
    11.06  Miotics
    Pilocarpine
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    Drops 1%, 2% and 4% 
       
    Minims® Pilocarpine 2%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    Preservative-free 
       
    11.07  Local anaesthetics to top
    Minims®Lidocaine Hydrochloride 4% with Fluorescein 0.25%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    Preservative free 
       
    Minims®Oxybuprocaine Hydrochloride 0.4%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
     
       
    Minims®Proxymetacaine Hydrochloride 0.5%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
     
       
    Minims®Tetracaine Hydrochloride(Amethocaine hydrochloride 0.5% and 1%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
     
       
    Controlled Drug Cocaine 4% Eye Drops
    View adult BNF View childrens BNF  Track Changes
    Formulary
    Red
    unlicensedUnlicensed
    For diagnosis of Horner's syndrome

    DCHFT: Not routinely stocked. 
       
    11.08  Miscellaneous ophthalmic preparations
    11.08.01  Tear deficiency, ocular lubricants, and astringents
    Hypromellose drops 0.3%
    View adult BNF View SPC online View childrens BNF  Track Changes
    First Choice
    Green
    Preserved or Preservative-free.

    Preservative-free - NOT RBCH- if admitted on this convert to alternative lubricant

    Other strengths of Hypromellose are considered non-formulary 
    Carbomer 980 Gel
    View adult BNF View SPC online View childrens BNF  Track Changes
    First Choice
    Green
    RBCH: Viscotears® 
    Liquid Paraffin ointment
    View adult BNF View SPC online View childrens BNF  Track Changes
    First Choice
    Green
    VitA-POS® or Xailin®

    For night time use. 
    Sodium Hyaluronate 0.2%
    View adult BNF View SPC online View childrens BNF  Track Changes
    First Choice
    Green

    Preservative-free

     
    Sodium Hyaluronate 0.4%
    View adult BNF View SPC online View childrens BNF  Track Changes
    First Choice Clinitas® Multi 10ml Preservative-free 
    Propylene Glycol and Polyethylene Glycol Drops (Systane®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    First Choice
    Green
    Preserved or Preservative-Free 
    Propylene Glycol 0.6% and Hydroxypropyl Guar (Systane Balance®)
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    First Choice
    Green
    Licensed for MGD only 
    Sodium Hyaluronate 0.1%
    View adult BNF View childrens BNF  Track Changes
    Second Choice
    Green
    Preservative-Free

    NOT RBCH – if admitted convert to 0.15% 
       
    Sodium Hyaluronate 0.15%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Second Choice
    Green
    Preservative-Free

     
       
    Carmellose drops 0.5%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Second Choice
    Green
    Preservative free

    NOT RBCH - if admitted on this convert to alternative lubricant. 
       
    Acetylcysteine drops 5% (Ilube®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Second Choice
    Amber
    Preserved 
       
    Ciclosporin 0.1% eye drops (Ikervis®)
    View adult BNF View SPC online  Track Changes
    Third Choice
    Amber
    In accordance with NICE TA369 and Dorset Dry Eye Pathway for severe keratitis in adult patients with dry eye disease that has not improved despite treatment with tear substitutes.

    Preservative-free

    RBCH: Consultant prescription only  
    Link  Comissioning statement for Ciclosporin in dry eye
    Link  NICE TA 369 Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears
       
    Sodium Chloride 5% drops / ointment
    View adult BNF View childrens BNF  Track Changes
    Formulary
    Amber
     
       
    Sodium hyaluronate 0.15% & Trehalose 3% (Thealoz Duo®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber

    Preservative free.

     
       
    Sodium hyaluronate 0.15%, Trehalose 3% & Carbomer 0.25% (Thealoz Duo Gel ®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber

    Preservative-free gel unit dose vials.

    Drops (Thealoz Duo drops) are significantly more cost-effective (see above)

     
       
    11.08.02  Ocular diagnostic and peri-operative preparations and photodynamic treatment
    11.08.02  Ocular diagnostic preparations
    Minims®Fluorescein Sodium drops 1%
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Green
    DCHFT: 2% on local formulary.
     
       
    Indocyanine green 25mg injection
     Track Changes
    Formulary
    Red
    unlicensedunlicensed

    DCHFT: Not routinely stocked. 
       
    11.08.02  Ocular peri-operative drugs to top
    Acetylcholine Chloride solution (Miochol-E®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
     
       
    Apraclonidine drops 0.5% (Iopidine®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
    DCHFT: 0.5% and 1% stocked. The two strengths have different licensed indications. 
       
    Diclofenac Sodium unit dose drops 0.1% (Voltarol® Ophtha )
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
     
       
    Ethanol 20% Eye Solution
    View adult BNF View childrens BNF  Track Changes
    Formulary
    Red
    Preservative-free


    Unlicensedunlicensed 
       
    Ketorolac trometamol drops 0.5% (Acular®)
    View adult BNF View SPC online View childrens BNF  Track Changes
    Formulary
    Amber
     
       
    Otrivine®
     Track Changes
    Formulary
    Red
    Xylometazoline paediatric nasal drops
    For hospital use during surgical procedures 
       
    Fluorescein sodium injection
     Track Changes
    Formulary
    Red
    unlicensedUnlicensed
    For hospital use during surgical procedures

    DCHFT: 20% injection stocked. 
       
    Potassium ascorbate drops 10%
     Track Changes
    Formulary
    Red
    Preservative free
    unlicensedUnlicensed 
       
    Sodium hyaluronate syringe
     Track Changes
    Formulary
    Red
    For hospital use during surgical procedures

    RBCH: Healonid®, Healonid 5®, Healonid GV® 
       
    11.08.02  Subfoveal choroidal neovascularisation
    Aflibercept (Eylea®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Red
    High Cost Medicine
    PbR excluded: Commissioned by CCG in accordance with NICE guidance - refer to Commissioning Statements. 
    Link  Commissioning statement aflibercept for neovascular (wet) AMD
    Link  Commissioning statement aflibercept for visual impairment caused by macular oedema secondary to retinal vein occlusion
    Link  Commissioning statement for aflibercept in diabetic macular oedema
    Link  Commissioning Statement on the use of aflibercept for treating choroidal neovascularisation in accordance with NICE TA486
    Link  NICE TA 307 - Aflibercept in combination with Irinotecan and Fluorouracil-based therapy for treating metastatic colorectal cancer that has progressed following prior oxaliplatin-based chemotherapy
    Link  NICE TA294: aflibercept solution for injection for treating wet age-related macular degeneration
    Link  NICE TA305: Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion
    Link  NICE TA346 Aflibercept for treating diabetic macular oedema
    Link  NICE TA409 Aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion
    Link  NICE TA486: Aflibercept for treating choroidal neovascularisation
       
    Ranibizumab (Lucentis®)
    View adult BNF View SPC online  Track Changes
    Formulary
    Red
    High Cost Medicine
    PbR excluded: Commissioned by CCG -In accordance with NICE TAs 155, 274, 283, 298.Ophthalmology consultant only.

  • Macular degeneration
  • Macular oedema(diabetic)
  • Macular oedema(retinal vein occlusion)
  • Choridal neovascularisation


  •  
    Link  Commissioning statement ranibizumab for choroidal neovascularisation associated with pathological myopia
    Link  Commissioning statement ranibizumab for diabetic macular oedema
    Link  Commissioning statement ranibizumab for diabetic macular oedema secondary to retinal vein occusion
    Link  NICE TA155:Ranibizumab and pegaptanib for the treatment of age-related macular degeneration
    Link  NICE TA274: Macular oedema (diabetic) - ranibizumab
    Link  NICE TA283: ranibizumab for treatment of visual impairment caused by macular oedema secondary to retinal vein occlusion
    Link  NICE TA298: ranibizumab for treatment of choroidal neovascularisation associated with pathological myopia
       
    Bevacizumab 1.25mg/0.05ml syringe for intravitreal injection
     Track Changes
    Formulary
    Red
    High Cost Medicine

    unlicensedUnlicensed

    Restricted Item RBCH: Approved for Eye specialist use in the following indications where there is no licensed product available:

    • Iris/drainage angle neovascularization - single injection
    • Pre-operative use to reduce the risk of vitreous hemorrhage during vitreoretinal surgery - single injection
    • Treatment of choroidal neovascularisation non-age related macular degeneration (AMD) or myopic CNV causes - repeated injection up to maximum frequency of monthly according to condition.
    • Treatment of choroidal neovascularisation due to age related macular degeneration where clinical benefit is present but patient falls outside the criteria for licensed drug treatment i.e. better than 6/12
     
       
    11.08.02  Vitreomacular traction
    Ocriplasmin
    View adult BNF View SPC online  Track Changes
    Formulary
    Red
    High Cost Medicine
    PbR excluded: Commissioned by CCG - See commissioning statement and NICE TA297. 
    Link  Ocriplasmin Commissioning Statement
    Link  NICE TA297: Ocriplasmin for treating vitreomacular traction
       
    11.08.03  Reduction of elevated intra-ocular pressure
    11.09  Contact lenses
    11.99.99.99  Miscellaneous to top
    11.99.99.99  Antifungals
    11.99.99.99  Cytotoxics / wound healing modulators
    Cytotoxic Drug Mitomycin C Eye Drops 0.02% and 0.04%
    View adult BNF  Track Changes
    Formulary
    Red
    unlicensedUnlicensed.

    For ocular surface neoplasms.

    DCHFT: Not routinely stocked. 
       
    11.99.99.99  Fibrinolytic drugs
    11.99.99.99  Glues - ocular
    Histacryl Blue® (Tissue Adhesive)
     Track Changes
    Formulary
    Red
     
       
    11.99.99.99  Immunosuppressants to top
    11.99.99.99  Treatment of burns
    Sodium Citrate 10.11 (equiv 6.5%) Eye Drops
     Track Changes
    Formulary
    Red
    unlicensedUnlicensed
    Preservative-free

    DCHFT: Not routinely stocked. 
       
    11.99.99.99  Visco-elastics
    11.99.99.99  Other
    Disodium Edetate 0.37%
     Track Changes
    Formulary
    Red
    unlicensedUnlicensed
    Preservative free 
       
    Hyaluronidase (Hyalase®)
    View adult BNF  Track Changes
    Formulary
    Red
     
       
    Holoclar® (Viable autologous human corneal epithelial cells )
    View SPC online  Track Changes
    Restricted Drug Restricted
    Red
    High Cost Medicine
    NHS England
    BlueTeq

    Only for use at Specialist Centres (University of Southampton and Oxford) in accordance with NICE TA 467.

     
    Link  NICE TA 467: Holoclar for treating limbal stem cell deficiency after eye burns
       
     ....
     Non Formulary Items
    Acetylcysteine 5% eye drops
    (Preservative free)

    View adult BNF View childrens BNF Track Changes
    Non Formulary unlicensedunlicensed
     
    Alteplase intravitreal injection

    View adult BNF View childrens BNF
    Non Formulary
     
    Amo Complete

    View adult BNF View childrens BNF
    Non Formulary
     
    Autologous Serum Eye Drops

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary Not routinely commissioned - Individual Funding Request Application should be made.
     
    Azelastine  (Optilast®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Bethamethasone  (Vista-Methasone®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Bethamethasone with Neomycin  (Vista-Methasone-N®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Bimatoprost drops 0.03%  (Lumigan®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Black
    0.01% strength is formulary preference.
     
    Boston Advance Cleaner

    View adult BNF View childrens BNF
    Non Formulary
     
    Boston Advance Conditioning Solution

    View adult BNF View childrens BNF
    Non Formulary
     
    Brilliant Peel®

    View adult BNF View childrens BNF
    Non Formulary
     
    Brimonidine Tartrate 0.2% with Timolol 0.5%  (Combigan®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Bromfenac  (Yellox®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Cenegermin  (Oxervate®)

    View adult BNF Track Changes
    Non Formulary
    Black

    Not recommended for the treatment of moderate or severe neurotrophic keratitis in adults as per NICE TA532.

    Link  NICE TA532: Cenegermin for treating neurotrophic keratitis
     
    Chlortetracycline

    View adult BNF View childrens BNF
    Non Formulary
     
    Dexamethasone with Antibacterials  (Tobradex®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Dipivefrine Hydrochloride  (Propine®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Emedastine  (Emadine®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Epinastine  (Relestat®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Erythromycin

    View adult BNF View childrens BNF
    Non Formulary
     
    Fluorouracil

    View adult BNF View childrens BNF
    Non Formulary
     
    Flurbiprofen Sodium  (Ocufen®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Gentamicin single use  (Minims® Gentamicin Sulphate)

    View adult BNF View childrens BNF
    Non Formulary
     
    Glycerol (glycerin)

    View adult BNF View childrens BNF
    Non Formulary
     
    Homatropine Hydrobromide

    View adult BNF View childrens BNF
    Non Formulary
     
    Hydrocortisone Acetate with Neomycin  (Neo-Cortef®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Hydrocortisone eye ointment

    View adult BNF View childrens BNF
    Non Formulary
     
    Hypromellose (0.32%,0.5%, 1%)
    (1%)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Black
    Dorset Ophthalmology Working Group and DMAG have identified preferred agents - see Dry Eye Prescribing Guidelines Sept 16
     
    Ketotifen  (Zaditen®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Levobunolol

    View adult BNF View childrens BNF
    Non Formulary
     
    Levofloxacin (inhaled)

    View adult BNF View childrens BNF Track Changes
    Non Formulary
    Black
    High Cost Medicine
    Not routinely commissioned by NHS England (for Cystic Fibrosis). As per IFR approval.
     
    Metipranolol  (Minims® Metipranolol)

    View adult BNF View childrens BNF
    Non Formulary
     
    Minims® Artificial Tears

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Black
    Preservative-free
    Hydroxyethylcellulose 0.44% and sodium chloride 0.35% unit dose drops

    Dorset Ophthalmology Working Group and DMAG have identified preferred agents - see Dry Eye Prescribing Guidelines Sept 16
     
    Minims® Saline

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Black
    Sodium Chloride unit dose drops 0.9%
    Preservative free

    Dorset Ophthalmology Working Group and DMAG have identified preferred agents - see Dry Eye Prescribing Guidelines Sept 16
     
    Nedocromil  (Rapitil®)

    View adult BNF View childrens BNF Track Changes
    Non Formulary
     
    Neomycin Sulphate

    View adult BNF View childrens BNF
    Non Formulary
     
    Neomycin Sulphate with antibacterials  (Neosporin®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Nepafenac  (Nevanac®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Oxysept 1 Step

    View adult BNF View childrens BNF
    Non Formulary
     
    Paraffin Yellow Soft

    View adult BNF View childrens BNF Track Changes
    Non Formulary
    Black
    Dorset Ophthalmology Working Group and DMAG have identified preferred agents - see Dry Eye Prescribing Guidelines Sept 16
     
    Pegaptanib

    View adult BNF View SPC online Track Changes
    Non Formulary
    Black
    High Cost Medicine
    PbR excluded: Commissioned by CCG in accordance with NICE TA155
    Not RBCH
    Link  NICE TA155: guidance on pegaptanib in AMD (August 2008)
     
    Pilocaprine long acting  (Pilogel®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Polymyxin B Sulphate eye ointment  (Polyfax®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Polyvinyl Alcohol drops 1.4%

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Black
    Dorset Ophthalmology Working Group and DMAG have identified preferred agents - see Dry Eye Prescribing Guidelines Sept 16
     
    Prednisolone 0.5% with Neomycin 0.5%  (Predsol-N®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Retinoic Acid Eye Ointment 0.05%

    View adult BNF View childrens BNF Track Changes
    Non Formulary

    unlicensed unlicensed

     Available from Berg Apotheke (Germany) 

     
    Rimexolone  (Vexol®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Rose Bengal  (Minims® Rose Bengal)

    View adult BNF View childrens BNF
    Non Formulary
     
    Saline Solution

    View adult BNF View childrens BNF
    Non Formulary
     
    Simple eye ointment

    View adult BNF View childrens BNF Track Changes
    Non Formulary
    Black
    Dorset Ophthalmology Working Group and DMAG have identified preferred agents - see Dry Eye Prescribing Guidelines Sept 16
     
    Sodium Hyaluronate

    View adult BNF View childrens BNF
    Non Formulary
     
    Sodium Hyaluronate with Lidocaine

    View adult BNF View childrens BNF
    Non Formulary
     
    Soybean oil unit dose eye drops  (Emustil®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Black
    Dorset Ophthalmology Working Group and DMAG have identified preferred agents - see Dry Eye Prescribing Guidelines Sept 16
     
    Tear flow test strips

    View adult BNF View childrens BNF
    Non Formulary
     
    Timolol 0.1% unit dose eye gel  (Tiopex®)

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary DCHFT: On local formulary.
     
    Timolol Once-daily  (Nyogel®)

    View adult BNF View childrens BNF Track Changes
    Non Formulary DCHFT: On local formulary.
     
    Total Care Daily Cleaner

    View adult BNF View childrens BNF
    Non Formulary
     
    Total Care Disinfecting and Wetting Solution

    View adult BNF View childrens BNF
    Non Formulary
     
    Trifluorothymidine eye drops

    View adult BNF View childrens BNF
    Non Formulary
     
    Tropicamide  (Mydriacyl®)

    View adult BNF View childrens BNF
    Non Formulary
     
    Verteporfin  (Visudyne®)

    View adult BNF View childrens BNF Track Changes
    Non Formulary
    Red
    DCHFT: On local formulary. Restricted to use in accordance with NICE TA68.
    Link  NICE NG82: Age-related macular degeneration
     
    Viscoat Viscoelastic

    View adult BNF View childrens BNF
    Non Formulary
     
    Vitamin/antioxidant supplements in AMD

    View adult BNF View SPC online View childrens BNF Track Changes
    Non Formulary
    Black
    Vitamin/antioxidant preparations are not recommended in age-related macular degeneration (AMD).
     
    Voriconazole Eye Drops

    View adult BNF View childrens BNF Track Changes
    Non Formulary

    unlicensed Unlicensed - available from NHS Manufacturing Units (e.g. Liverpool) 

    May be required inresistant cases of acanthamoeba.

     
      
    Key
    note Notes
    Section Title Section Title (top level)
    Section Title Section Title (sub level)
    First Choice Item First Choice item
    Non Formulary Item Non Formulary section
    Restricted Drug
    Restricted Drug
    Unlicensed Drug
    Unlicensed
    Track Changes
    Display tracking information
    click to search medicines.org.uk
    Link to adult BNF
    click to search medicines.org.uk
    Link to children's BNF
    click to search medicines.org.uk
    Link to SPCs
    Cytotoxic Drug
    Cytotoxic Drug
    CD
    Controlled Drug
    High Cost Medicine
    High Cost Medicine
    Cancer Drugs Fund
    Cancer Drugs Fund
    NHSE
    NHS England
    Homecare
    Homecare
    CCG
    CCG

    Traffic Light Status Information

    Status Description

    Green

    May be initiated, stabilised and maintained in primary, secondary or tertiary care  

    Amber

    Amber drug - without shared care  

    Amber SCG

    Amber drug - with shared care guideline  

    Red

    For secondary or tertiary care initiation and long-term maintenance of prescribing  

    Black

    Not recommended  

    netFormulary