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Royal United Hospitals Bath NHS Foundation Trust
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 Formulary Chapter 11: Eye - Full Chapter
Notes:

Ophthalmology-related Prescribing Guidance

Please see our Prescribing Guidelines page for all prescribing guidance relating to this chapter.

Ophthalmology-related Shared Care Agreements

There are no shared care agreements (SCAs) relating to this chapter.

 

Self-care

Many of the products in this chapter are available for purchase over-the-counter, and patients are encouraged to self-care, with the support of their community pharmacist, in the first instance.

For further information on self-care & the NHS, please refer to https://www.england.nhs.uk/medicines/conditions-for-which-over-the-counter-items-should-not-routinely-be-prescribed/

 Details...
11.01  Administration of drugs to the eye
 note 

If using multiple preparations, leave 5 minutes before each administration to ensure complete absorption of each preparation. Drops should be used before ointments.

Eye drop administration aids for patients with manual dexterity problems (including the elderly, visually impaired, arthritic) can be purchased from most community pharmacies or prescribed on FP10 prescriptions. Refer to the Drug Tariff for further details.

Preservative free products should be prescribed for patients with true preservative allergy, as diagnosed by a specialist.

11.02  Control of microbial contamination
 note 

Nov 2019 - Guidance on the In Use Shelf Life for Eyedrops and Eye Ointments  

Also refer to BNF and local guidelines for information on the control of microbial contamination.

In outpatient departments and eye surgery single-use application packs should be used.

11.03  Anti-infective eye preparations
 note 

Please refer to Primary Care Antibiotic Guidance

For information regarding 'specials' please see Royal College of Opthalmologists Special Products August 2016

11.03.01  Antibacterials
Chloramphenicol 
(Drops)
View adult BNF View SPC online
First Choice
Self
  • 0.5% eye drops
  • 0.5% minims available for patients allergic to preservatives, administering more than 6 times a day, undergoing eye surgery
  • Eye drops available OTC for adults and children over 2 years
 
Chloramphenicol 
(Ointment)
View adult BNF View SPC online
First Choice
Self
  • 1% eye ointment
  • Eye ointment available OTC for adults and children over 2 years
 
Amikacin 
(Injection)
View adult BNF View SPC online
Formulary
Red
  • 500mg/2ml solution for injection 
  • GWH only. For treatment of Acanthamoeba keratitis.
  • Non formulary at RUH and SFT
 
   
Cefuroxime  
(Drops)
View adult BNF View SPC online
Formulary
Red
  • 5% eye drops
  • 5% preservative-free eyedrops (GWH only)
 
   
Chlortetracycline 
(Ointment)
View adult BNF View SPC online
Formulary
Red
  • 1% eye ointment 
  • RUH only. Non formulary at GWH and SFT
 
   
Ciprofloxacin 
(Drops)
View adult BNF View SPC online
Formulary
  • 0.3% eye drops

  • Green Salisbury
  • Red RUH and GWH - For corneal crystallisation and endophthalmitis
 
   
Erythromycin 
(Ointment)
View adult BNF View SPC online
Formulary
Red
  • 0.5% eye ointment
  • GWH only for suspected chlamydia in neonates on the advice of paediatrician
  • Non formulary at RUH and SFT
 
   
Fusidic Acid 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 1% eye drops

Fusidic acid eye drops are no longer included in primary care guidance for the management of bacterial conjunctivitis due to high cost (£29.06 per 5g May 2019) and poor activity for a self-limiting condition. 

Use should be restricted to people who:
- Are pregnant
- Have a personal or family history of blood dyscrasias, such as aplastic anaemia
- Are intolerant of chloramphenicol
- Need a twice-a-day treatment for infective conjunctivitis
See CKS topic for more information

 

 
   
Gentamicin 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 0.3% eye drops
 
   
Gentamicin 
(Drops)
View adult BNF View SPC online
Formulary
  • Red - GWH.
  • Non-formulary - SFT & RUH.
  • 1.5 % preservative-free eye drops.
 
   
Levofloxacin 
(Drops)
View adult BNF View SPC online
Formulary
  • 5mg/ml eye drops

  • Green Salisbury
  • Amber BaNES and Swindon
 
   
Moxifloxacin 
(Tablets)
View adult BNF View SPC online
Formulary
Red
  • 400mg tablets 
  • GWH only - For the treatment of endophthalmitis, 400mg OD for 10 days.
  • Non formulary at RUH and SFT
 
   
Ofloxacin 
(Drops)
View adult BNF View SPC online
Formulary
  • 0.3% eye drops

  • Amber in BaNES and Swindon
  • Green in Salisbury

 

 
   
Penicillin 
(Injection)
View adult BNF View SPC online
Formulary
Red
  • 5000 units in 1ml eye drops
  • GWH only. Non formulary at RUH and SFT
 
   
Polihexanide 
(Drops)
View adult BNF View SPC online
Formulary
Red
  • 0.02% eye drops
  • GWH and RUH only. Non formulary at SFT
 
   
Propamidine Isetionate

(Drops and ointment)
View adult BNF View SPC online
Formulary
Red
  • 0.1% eye drops
  • 0.15% ointment
  • GWH only. Non formulary at RUH and SFT
 
   
Vancomycin  
(Injection)
View adult BNF View SPC online
Formulary
Red
  • GWH only. For intravitreal injection
  • Non formulary at RUH and SFT
 
   
11.03.02  Antifungals to top
 note 

Antifungal eye preparations are not generally available and are unlicensed. Only use under specialist advice.

Amphotericin 
(Intravitreal injection)
Formulary
Red
  • GWH only - Only for treatment of fungal endophthalmitis after consultant or senior ophthalmologist approval. See information sheet for dilution instructions.
  • Non formulary at RUH and SFT
 
   
11.03.03  Antivirals
Ganciclovir 
(Gel)
View adult BNF View SPC online
Formulary
  • 0.15% eye gel

  • Green in Salisbury
  • Amber in Swindon and BaNES - ONLY for patients with corneal stromal herpes simplex keratitis, aciclovir-resistant herpes simplex keratitis & herpetic keratouveitis on the advice of a Consultant ophthalmologist

 

 
   
11.04  Corticosteroids and other anti-inflammatory preparations
 note 

See MHRA Drug Safety Update: rare risk of central serous chorioretinopathy with local and systemic administration of corticosteriods August 2017

For information regarding 'specials' please see Royal College of Opthalmologists Special Products August 2016

11.04.01  Corticosteroids
Betamethasone 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 0.1% eye drops

 

 
   
Betamethasone with Neomycin

(Drops)
View adult BNF View SPC online
Formulary
Amber
  • Betamethasone sodium phosphate 0.1% with Neomycin sulfate 0.5% eye drops 

 

 
   
Dexamethasone 
(Drops)
View adult BNF View SPC online
Formulary
Amber
  • 0.1% eye drops

 

 
   
Dexamethasone (Minims®)
(Drops)
View adult BNF View SPC online
Formulary
    • Amber - Bath & Swindon
    • Non formulary - Salisbury
    • 0.1% preservative free eye drops in 0.5ml unit doses

 

 
   
Dexamethasone  (Ozurdex®)
(Intravitreal implant)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG
BlueTeq
  • 700 micrograms intravitreal implant in applicator
  • For the treatment of adults with macular oedema following either branch retinal vein occlusion or central retinal vein occlusion ONLY in line with local commissioning criteria and NICE TA229.
  • For the treatment of patients with sight problems caused  diabetic macular oedema, in line with NICE TA349.
  • For the treatment of patients with non-infectious uveitis, in line with NICE TA460Only available in specialist centres (not RUH or SFT).

 

 
Link  NICE TA229: Macular oedema secondary to retinal vein occlusion
Link  NICE TA349: Diabetic Macular Oedema
Link  NICE TA460: Non-infectious uveitis
   
Dexamethasone with Neomycin and Polymyxin B sulphate

(Drops and ointment)
View adult BNF View SPC online
Formulary
Amber
  • Dexamethasone 1 mg/gram with neomycin 3500 units/gram and polymyxin B sulfate 6000 unit per 1 gram in 3.5g eye ointment
  • Dexamethasone 1 mg/ml with hypromellose 5 mg/ml with neomycin (as neomycin sulfate) 3500 units/ml with polymyxin B sulfate 6000 units/ml in 5ml eye drops
 
   
Dexamethasone with Tobramycin

(Drops)
View adult BNF View SPC online
Formulary
Green
  • Dexamethasone 1 mg/ml with tobramycin 3 mg/ml eye drops.
  • Salisbury only
  • Non formulary in BaNES and Swindon
 
   
Fluocinolone (Iluvien®)
(Intravitreal implant)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG
BlueTeq
  • For the treatment of chronic diabetic macular oedema after an inadequate response to prior therapy. In line with NICE TA301 Nov 2013.  Patients need to have gained 10 or more ETDRS letters of visual acuity between baseline and month 36 to receive a further implant at month 36 according to NICE TA301.
  • Note: concurrent treatment to both eyes not recommended (SPC).
  • A single implant releases fluocinolone for up to 36 months.
  • Implantation may not be repeated more frequently than every 36 months due to lack of evidence base of benefit.
 
Link  Iluvien Educational Risk Minimisation Materials
Link  NICE TA301: Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular oedema after an inadequate response to prior therapy
Link  NICE TA590: Fluocinolone acetonide intravitreal implant for treating recurrent non-infectious uveitis
   
Fluorometholone 
(Solution)
View adult BNF View SPC online
Formulary
Amber
  • 0.1% ophthalmic solution
 
   
Hydrocortisone sodium phosphate.

View adult BNF View SPC online
Formulary
Red
  • 3.35mg/ml eye drops 0.4ml unit dose
 
   
Loteprednol 
View adult BNF View SPC online
Formulary
Red
  • Salisbury only
  • Non formulary at RUH and GWH
 
   
Prednisolone 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 0.5% ophthalmic drops, 1% ophthalmic drops
  • Preservative free available if indicated

 

 
   
Prednisolone 
(Drops)
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Red
  • 0.1% and 0.3% ophthalmic drops  NOTE STRENGTHS
  • GWH only - For use in herpes simplex keratitis only
  • These strengths are non formulary at RUH and Salisbury
 
   
11.04.02  Other anti-inflammatory preparations
Antazoline 0.5% with Xylometazoline 0.05%

(Drops)
View adult BNF View SPC online
Formulary
Self
  • BaNES only
  • Non formulary in Swindon and Salisbury
  • Xylometazoline hydrochloride 500 microgram, antazoline sulfate 5mg per 1ml
 
   
Olopatadine 
(Drops)
View adult BNF View SPC online
Formulary
  • Green - Salisbury & Swindon - First-line antihistamine.
  • Non formulary - Bath.
  • 1mg/1ml ophthalmic drops.
 
   
Ketotifen (Ketofall®)
(Drops)
View adult BNF
Formulary
  • Amber - Salisbury & Swindon - 2nd-line after Olopatidine.
  • Non formulary - Bath.
  • 0.25mg/ml single dose unit drops SPC here.
 
   
Neodocromil 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • Salisbury only
  • Non formulary in Bath and Swindon
  • 2% eye drops
 
   
Sodium Cromoglicate

(Drops)
View adult BNF View SPC online
Formulary
Self
  • 2% ophthalmic drops
  • If issuing FP10, ensure that prescriptions are written for 13.5ml, not 10ml or ‘1op’ as these preparations are ‘over-the-counter’ products and are more expensive.
 
   
11.05  Mydriatics and cycloplegics to top
11.05  Antimuscarinics
Atropine 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 1% ophthalmic drops

 

 
   
Atropine Sulphate 
(Single use drops)
View adult BNF View SPC online
Formulary
Green
  • 1% single use minims

 

 
   
Cyclopentolate drops

(Drops and minims)
View adult BNF View SPC online
Formulary
Green
  • 0.5% and 1% ophthalmic drops
  • 0.5% and 1% minims

 

 
   
Tropicamide 
(Ophthalmic drops )
View adult BNF View SPC online
Formulary
Green
  • 0.5% and 1%
 
   
11.05  Sympathomimetics
Phenylephrine 5.4mg and Tropicamide 0.28mg Ophthalmic Insert

View adult BNF View SPC online
Formulary
Red
  • RUH and Salisbury only
  • Non formulary at GWH
 
   
Phenylephrine Hydrochloride

View adult BNF View SPC online
Formulary
Red
  • Phenylephrine 2.5% and 10% eyedrops
  • GWH only - Phenylephrine 1% injection for consultant/senior ophthalmologist approval
 
   
11.06  Treatment of glaucoma
11.06  Beta-blockers
 note 

Systemic absorption may occur with eye drops containing beta-blockers so these are contra-indicated in patients with bradycardia, heart block and uncontrolled heart failure and should be used with extreme care in patients with asthma.

Timolol 
(Ophthalmic drops)
View adult BNF View SPC online
First Choice
Green
  • 0.25% and 0.5% drops

 

 

 
Betaxolol 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 0.5% ophthalmic drops and 0.25% ophthalmic solution

 

 
   
Timolol 
(Preservative Free drops)
View adult BNF View SPC online
Formulary
Green
  • BaNES and Swindon
  • Non formulary in Salisbury
  • 2.5mg/ml and 5mg/ml preservative free ophthalmic drops
 
   
Timolol 
(Ophthalmic gel)
View adult BNF View SPC online
Formulary
  •  Amber - Swindon
  • Non formulary- Bath & Salisbury
  • 0.1 % ophthalmic gel
 
   
11.06  Prostaglandin analogues to top
Latanoprost 
(Drops)
View adult BNF View SPC online
First Choice
Green
  • 50microgram/ml ophthalmic drops
  • Preservative free available if indicated as per BSW glaucoma guidance

 

 
Bimatoprost with Timolol

(Drops)
View adult BNF View SPC online
Formulary
Green
  • 300micrograms and 5mg/ml combination ophthalmic drops

 

 
   
Latanoprost 0.005% with Timolol 0.5%

(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • Latanoprost 50micrograms, Timolol 5mg/ml
  • Note: Fixapost® preservative free included on formulary at SFT 
 
   
Travoprost 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 40microgram ophthalmic drops

 

 
   
Travoprost with Timolol

(Drops)
View adult BNF View SPC online
Formulary
Green
  • 40microgram with 5mg/ml Timolol ophthalmic drops
 
   
Bimatoprost 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 100microgram/ml ophthalmic drops
  • 300microgram/ml preservative free single use eyedrops available where indicated as per BSW glaucoma guidance
 
   
11.06  Sympathomimetics
Brimonidine Tartrate

(Drops)
View adult BNF View SPC online
Formulary
Green
  • 0.2% ophthalmic eye drops
  • Note - higher risk of side-effects and sensitivity.

 

 
   
11.06  Carbonic anhydrase inhibitors and systemic drugs
Brinzolamide 1% with Timolol 0.5%

View adult BNF View SPC online
Second Choice
Green
  • Brinzolamide 1% with Timolol 0.5% 
 
   
Acetazolamide 
(Tablets/capsules)
View adult BNF View SPC online
Formulary
  • Green BaNES and Salisbury for glaucoma
  • Amber Swindon for glaucoma
  • 250mg tablets and 250mg MR capsules (NB capsules more costly and stock shortages until at least July 2020)
  • Note: at RUH and GWH, acetazolamide is included on the formulary for idiopathic intracranial hypertension as Amber Unlicensed indication
  • Note - Private prescription only for prophylaxis of mountain sickness. Not licensed and NOT for prescribing on NHS. For further information see link below 
 
Link  SPS: Prevention of Acute Mountain Sickness
   
Acetazolamide Injection

View adult BNF View SPC online
Formulary
Red
  • 500mg injection
 
   
Brinzolamide 
(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • 1% eye drops

 

 
   
Brinzolamide 10mg/ml & brimonidine 2mg/ml

View adult BNF View SPC online
Formulary
Green
  • ophthalmic drops containing 10 mg/mL of brinzolamide and 2 mg/mL of brimonidine tartrate equivalent to 1.3 mg of brimonidine.

BaNES/Wilts - For use as per Glaucoma guidance 
Swindon - Not on formulary

 
   
Dorzolomide 
(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • 2% eye drops
 
   
Dorzolomide 2% with Timolol 0.5%

(Ophthalmic solution)
View adult BNF View SPC online
Formulary
Green
  • 5ml ophthalmic drops

 

 
   
11.06  Miotics
Pilocarpine 
(Drops)
View adult BNF View SPC online
Formulary
Green
  • 2% and 4% eyedrops.
  • 2% preservative-free minims (Swindon only).

 

 
   
11.07  Local anaesthetics
Lidocaine 4% with Fluorescein 0.25%

View adult BNF View SPC online
Formulary
Green
  • 0.5ml unit dose.
 
   
Oxybuprocaine 
(Drops)
View adult BNF View SPC online
Formulary
Red
  • 0.4% single use drops
 
   
Proxymetacaine 
(Drops)
View adult BNF View SPC online
Formulary
  • Red at RUH
  • Green in Salisbury and Swindon
  • 0.5% single use drops
 
   
Tetracaine 
(Drops)
View adult BNF View SPC online
Formulary
Red
  • 0.5% and 1% single use drops
 
   
11.08  Miscellaneous ophthalmic preparations to top
11.08.01  Tear deficiency, ocular lubricants, and astringents
 note 

Self-care of tear deficiency, ocular lubricants and astringents

Please see BSW Dry Eye Guidance

Many of the products in this section are available to purchase over-the- counter. Patients are encouraged to self-care with the support of their community pharmacist, in the first instance.

 

Hypromellose 
(Ophthalmic drops 0.3%)
View adult BNF View SPC online
First Choice
Self
  • 0.3% drops 10ml
 
Hypromellose 
(Ophthalmic drops Preservative Free)
View adult BNF View SPC online
First Choice
Green
  • 0.3% drops 10ml
  • Evolve is the most cost-effective preservative-free hypromellose preparation in primary care
  • Swindon only - use Hydromoor brand in secondary care
 
Carbomer 
(Ophthalmic liquid gel)
View adult BNF View SPC online
First Choice
Green
  • 0.2% gel 10g
 
Carbomer 980 eye drops

(Ophthalmic liquid gel)
View adult BNF View SPC online
First Choice
Green
  • 0.2% gel 10g
  • Suitable for contact lense wearers
 
Carmellose 
(Ophthalmic drops)
View adult BNF View SPC online
First Choice
Green
  • 1% drop 10ml
  • Cellusan is the most cost-effective preservative-free carmellose preparation in primary care
  • Swindon only - Use Celluvisc SDUs in secondary care.
 
Sodium Hyaluronate 
(Ophthalmic drops)
View adult BNF View SPC online
Second Choice
  • 0.2% drops 10ml (Hydramed®)
  • 0.4% drops 10ml (Viz-Hyal®)
  • Preservative-free
  • To be prescribed in line with BSW Dry Eye Guidance
  • NOTE 0.4% strength is AMBER TLS in Swindon and only for use in Sjogren's
 
   
Acetylcysteine 
(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Amber
  • Acetylcysteine eye drops 5%, hypromellose 0.35% 10ml (includes benzalkonium chloride, disodium edetate)
  • Specialist initiation - Only if filamentary keratitis present.
 
   
Carboxymethylcellulose, glycerine & castor oil eye drops

View adult BNF View SPC online
Formulary
Self
  • Carmellose 0.5ml, glycerol 1%, castor oil 0.25% 10ml
 
   
Ciclosporin (Ikervis®)
(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Amber
  • 0.1% drops (1 mg/mL eye drops, emulsion)
  • Note - Ensure correct product is prescribed; available products have different licensing information and TLS. 
  • Ikervis ® is licensed for the treatment of severe keratitis in adult patients with dry eye disease, which has not improved despite treatment with tear substitutes.
  • Verkazia®  is licensed for the treatment of severe vernal keratoconjunctivitis (VKC) in children from 4 years of age and adolescents. See here
 
Link  NICE TA369: Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears
   
Liquid Paraffin eye ointment
(Lacri-lube®)
(Opthalmic oinment)
View adult BNF
Formulary
Amber
  • GWH for recurrent erosions only. Not on formulary at RUH/SFT
  • Consider Hylo-night (formerly VitA-POS or Hydramed night)
 
   
Propylene glycol  
(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • 10ml
 
   
Propylene glycol 0.3% and polyethlene glycol 0.4% with hydroxypropyl guar

(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • 10ml
 
   
Retinol palmitate with soft paraffins

View adult BNF View SPC online
Formulary
Self
  • 5g Preservative-free ointment

Better known by brand names:

- Hydramed Night® (Retinol palmitate 250iu/g, liquid paraffin, white soft paraffin, wool fat) 5g (PF) 3/12 expiry

- VitA-POS® (Retinol palmitate 250iu/g, liquid paraffin, wool fat) 5g (PF) 6/12 expiry NOTE from April 2020, VitA-POS is rebranding as HYLO NIGHT. The ointment ingredients and composition remaining the same as VitA-POS.

 
   
Sodium Chloride 
(Balanced salt solution)
Formulary
Red
  • Eye irrigation solutions 19ml, 500ml
 
   
Sodium Chloride 0.9%

(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Green
  • 0.9% drops
 
   
Sodium Chloride 0.9%

(Single use ophthalmic drops)
Formulary
Green
  • 0.9% 0.5ml Preservative-free
 
   
Sodium Chloride 5% 
View adult BNF View SPC online
Formulary
Amber

Sodium chloride 5% (preserved) eyedrops for patients with corneal oedema or corneal erosions on the advice of a Consultant Ophthalmologist. In primary care these should be prescribed as Hypersal 5% eyedrops or Sodium Chloride 5% eyedrops (Alissa®) as other unlicensed products are prohibitively expensive.

Sodium Chloride 5% PF eye ointment for patients with corneal oedema or corneal erosions, unable to tolerate preserved drops, on the advice of a Consultant Ophthalmologist. In primary care these should be prescribed as Sodium Chloride 5% PF eye ointment (Alissa®) as other unlicensed products are prohibitively expensive.

Please note - Sodium Chloride 5% eye products not on formulary at SFT

 
   
Sodium Hyaluronate 0.1%, Co-enzyme Q10 0.1%, Vitamin E

(Ophthalmic drops)
View adult BNF View SPC online
Formulary
Amber
  • 0.1% Preservative-free (VisuXL®)
  • 2 month expiry
  • Specialist initiation only in line with BSW dry eye guidance 
 
   
Ciclosporin 
(Ophthalmic ointment)
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Red
  • 0.2% eye ointment - Unlicensed preparation
  • GWH only - ONLY for patients who respond to ciclosporin but fail to tolerate Ikervis presentation. Only to be prescribed on yellow GWH hospital outpatient prescription and NOT FP10
  • Non formulary in RUH and SFT

 

 
   
Hypromellose 2% in balanced salt solution (HPMC)

Unlicensed Drug Unlicensed
Red
  • For use within GWH only

 

 
   
11.08.02  Ocular diagnostic and peri-operative preparations and photodynamic treatment
Acetylcholine 
(Intra-ocular irrigation)
View adult BNF View SPC online
Formulary
Red
  • 20mg powder and solvent for solution for intraocular irrigation
 
   
Apraclonidine 
(Single use opthalmic drops)
View adult BNF View SPC online
Formulary
Red
  • 0.1% solution
 
   
Cefuroxime intracameral injection
(Aprokam®)
(injection)
View adult BNF View SPC online
Formulary
Red
  •  3mg in 0.3ml pre-prepared injection.
  •  50mg vial.
 
   
Diclofenac 
(Drops)
View adult BNF View SPC online
Formulary
  • Green Swindon - Pre-operative & immediately post - operatively. For short-term pain relief in episcleritis, cornial abrasion or foreign bodies. Avoid single use except in allergy to preservatives
  • Red RUH (Single use eye drops 0.1%)
  • Non formulary in Salisbury
 
Link  Eye topical NSAIDs 3Ts
   
Fluorescein 
View adult BNF View SPC online
Formulary
Red
  • 1% and 2% minims
  • Ophthalmic strips
  • GWH only
  • Non formulary at RUH and Salisbury
 
   
Ketorolac 
(Drops)
View adult BNF View SPC online
Formulary
Red
  • 0.5% ophthalmic drops
  • Note at GWH - For inflammation requiring extended treatment (up to 21 days) following ocular surgery
 
Link  Eye topical NSAIDs - 3TS
   
Nepafenac (Nevanac)
View adult BNF View SPC online
Formulary
Amber
  • Salisbury only
  • Non formulary in BaNES and Swindon
 
   
Perflurodecaline (Heavy Liquid)
(Injection)
View adult BNF View SPC online
Formulary
  •  Red- GWH - For use in Ophthalmology.
  •  Non-formulary- SFT & RUH.
  •  5ml vial.
 
   
Sodium Hyaluronate 
(Pre-filled syringe 1%)
View adult BNF View SPC online
Formulary
Red
 
   
Tisseel 
(RTU Kit)
View adult BNF View SPC online
Formulary
  •  Red - GWH - For use in Ophthalmology.
  •  Non-formulary - SFT & RUH
 
   
Mydrane Injection 
(0.2 ml solution contains 0.04 mg of tropicamide, 0.62 mg of phenylephrine hydrochloride and 2 mg of lidocaine hydrochloride)
View SPC online
Restricted Drug Restricted
Red

GWH Eye Theatre Use Only During Post COVID-19

  • Intracameral injection
  • Added to formulary for 6 months during post COVID-19 (review date Jan 21)
 
   
11.08.02  Subfoveal choroidal neovascularisation
 note 

BSW STP ophthalmology Blueteq pathways for Aflibercept and Ranibizumab

Aflibercept (Eylea®)
(Intravitreal injection)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG
BlueTeq
 
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
   
Bevacizumab  (Avastin®)
(Intravitreal injection)
View adult BNF View SPC online
Formulary
Red
CCG
BlueTeq
 
Link  Policy for Bevacizumab for the treatment of rubeotic/neovascular glaucoma and uncontrolled Proliferative Diabetic Retinopathy prior to laser or vitrectomy (adults)
Link  Policy for use of Avastin® (bevacizumab) under the NICE threshold in wet AMD
   
Ranibizumab (Lucentis®)
(Intravitreal injection)
View adult BNF View SPC online
Formulary
Red
High Cost Medicine
CCG
BlueTeq
 
Link  NICE TA155: Ranibizumab and pegaptanib for the treatment of age-related macular degeneration
Link  NICE TA274: Ranibizumab for treating diabetic macular oedema
Link  NICE TA283:Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion
Link  NICE TA298: Ranibizumab for treating choroidal neovascularisation associated with pathological myopia
   
11.09  Contact lenses
 note 

Contact lense solutions are not allowed on FP10 prescriptions.

Refer to BNF for recommendations reagrding contact lenses and drug treatment

11.99.99.99  Miscellaneous to top
 note 

Nutritional supplements for age-related macular degeneration are NON-FORMULARY. See 9.6.7 for further information 

 

Disodium edetate 
(Eyedrop)
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Red
  • 0.37% eyedrop Unlicensed
  • RUH and GWH - for chelation of cornea for calcific band keratopathy.
  • Not on formulary at SFT
 
   
Cytotoxic Drug Fluorouracil 
(Injection)
View adult BNF View SPC online
Unlicensed Drug Unlicensed
Red
  • Swindon only - used in theatre intra-operatively (trabeculectomy) and for needling of trabeculectomy post-op. Special chemotherapeutic agent manufactured for individual patients. 48 hours notice required. Consultant ophthalmologist prescription only.
  • For licensed indications for fluorouracil see chapter 8.1.3 and chapter 13.8.1(topical)
  • Non formulary at RUH and SFT

 

 
   
 ....
 Non Formulary Items
Acetylcysteine 10% eye drops


View adult BNF View SPC online
Non Formulary
 
Aciclovir 
(Ointment)

View adult BNF View SPC online
Non Formulary
  • 3% eye ointment

No longer on formulary due to lack of availability. See memo below

Link  Memo regarding availability
 
Adalimumab     (Imraldi®Amgevita® Humira®)Black Triangle
(Ophthalmology)

View adult BNF View SPC online
Restricted Drug Restricted
High Cost Medicine
NHS England
  • Non-Formulary EXCEPT when used for Uveitis in accordance with NICE TA 460 from Specialist Centres 
  • Check Trust contracting arrangements.
 
Amo Complete 

View adult BNF View SPC online
Non Formulary
 
Azelastine (Optilast®)

View adult BNF View SPC online
Non Formulary
 
Azithromycin (Azyter®)
(ophthalmic)

View adult BNF View SPC online
Non Formulary
 
Benzylpenicillin  
(ophthalmic)

View adult BNF View SPC online
Non Formulary
 
Boston Advance Cleaner


View adult BNF View SPC online
Non Formulary
 
Boston Advance Conditioning Solution


View adult BNF View SPC online
Non Formulary
 
Carbomer 

View adult BNF View SPC online
Non Formulary
 
Carbomers 

View adult BNF View SPC online
Non Formulary
 
Carmellose Sodium (Carmize®)

View adult BNF View SPC online
Non Formulary
 
Carteolol 
(Ophthalmic drops 1%)

View adult BNF View SPC online
Non Formulary
 
Ceftazidime  
(ophthalmic)

View adult BNF View SPC online
Non Formulary
 
Cenegermin 

View adult BNF View SPC online
Non Formulary
Link  NICE TA532: Cenegermin for treating neurotrophic keratitis
 
Controlled Drug  Cocaine 

View adult BNF View SPC online
Non Formulary
 
Commercial eye hygiene preparations


View adult BNF View SPC online
Non Formulary

Commercial eye hygiene preparations are non-formulary and not recommended for prescribing due to limited evidence to support their effectiveness over usual eyelid hygiene methods.

Do not routinely prescribe commercial eyelid hygiene preparations (such as Blephasol®, Blephaclean®, Blephagel®, Suppranettes® wipes or lotions, or eye compresses like Hot Eye Compress®, Meibopatch®, MGDRx Eye Bag®). These are available for self-purchase OTC.

Further information for prescribers:

  • Advise and support patients to develop a lid hygiene routine using a home-made warm compress. See CKS
  • Supply patients with an information leaflet from Moorfield’s Eye Hospital
 
Dipivefrine Hydrochloride
(Propine®)

View adult BNF View SPC online
Non Formulary
 
Econazole 1% eye drops


View adult BNF View SPC online
Non Formulary
 
Emedastine (Emadine®)

View adult BNF View SPC online
Non Formulary
 
Epinastine (Relestat®)

View adult BNF View SPC online
Non Formulary
 
Foscarnet intravitreal injection


View adult BNF View SPC online
Non Formulary
 
Homatropine 
(Opthalmic drops 1%)

View adult BNF View SPC online
Non Formulary
 
Hydroxyethylcellulose
(Minims® Artificial Tears)

View adult BNF View SPC online
Non Formulary
 
Hydroxypropyl Guar (Systane®)

View adult BNF View SPC online
Non Formulary
 
Idebenone (Raxone®)

View adult BNF View SPC online
Non Formulary
 
Levobunolol 
(Drops)

View adult BNF View SPC online
Non Formulary
  • 0.5% ophthalmic drops
  • Note Jan 2020 - Non-formulary for new patients as discontinued by manufacturer. See glaucoma guidance for alternatives  

 

 
Liquid Paraffin and Liquid Paraffin light eye drops


View adult BNF View SPC online
Non Formulary
 
Liquid Paraffin eye ointment


View adult BNF View SPC online
Non Formulary
 
Lodoxamide (Alomide®)

View adult BNF View SPC online
Non Formulary
 
Metipranolol (Minims® Metipranolol)

View adult BNF View SPC online
Non Formulary
 
Miconazole 1% eye drops


View adult BNF View SPC online
Non Formulary
 
Neomycin Eye drops 

View adult BNF View SPC online
Non Formulary
 
Optive ® Fusion


View adult BNF View SPC online
Non Formulary
 
Oxysept 1 Step 

View adult BNF View SPC online
Non Formulary
 
Paraffin Yellow Soft

(Simple eye ointment)

View adult BNF View SPC online
Non Formulary
 
Pegaptanib Sodium (Macugen®)

View adult BNF View SPC online
Non Formulary
High Cost Medicine
 
Polymyxin B Sulphate eye ointment
(Polyfax®)

View adult BNF View SPC online
Non Formulary
 
Polyvinyl Alchohol (SnoTears®)

View adult BNF View SPC online
Non Formulary
 
Polyvinyl Alcohol (Liquifilm Tears or Sno Tears®)

View adult BNF View SPC online
Non Formulary
 
Povidone iodine 5% 
(ophthalmic)

View adult BNF View SPC online
Non Formulary
 
Prednisolone 0.5% with Neomycin 0.5%
(Predsol-N®)
(Ophthalmic drops)

View adult BNF View SPC online
Non Formulary

Discontinued

 
Sodium cromoglicate preservative free


View adult BNF View SPC online
Non Formulary
 
Sodium Hyaluronate 
(Ophthalmic drops)

View adult BNF View SPC online
Non Formulary

Jan 2020 - Hylo-tears and Hylo-forte brands no longer included on the formulary. See BSW dry eye guidance for preferred brands of sodium hyaluronate.

 
Soybean oil unit dose eye drops
(Emustil®)

View adult BNF View SPC online
Non Formulary
 
Tafluprost and Timolol
(Taptiqom®)

View adult BNF View SPC online
Non Formulary
 
Total Care Daily Cleaner


View adult BNF View SPC online
Non Formulary
 
Total Care Disinfecting and Wetting Solution


View adult BNF View SPC online
Non Formulary
 
Trifluorothymidine eye drops


View adult BNF View SPC online
Non Formulary
 
Verteporfin (Visudyne®)
(Injection)

View adult BNF View SPC online
Non Formulary
Red
High Cost Medicine
Link  NICE TA68: Photodynamic therapy for age related macular degeneration
 
  
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 SPCs
SMC
Scottish Medicines Consortium
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
Blueteq
High Cost Drug Approval System

Traffic Light Status Information

Status Description

Red

RED - Hospital only – to be prescribed by a specialist and supplied from secondary care ONLY throughout treatment.  

Amber

Amber medicines are considered suitable for GP prescribing following specialist initiation or recommendation.  

Amber with Shared Care

Shared Care - these medicines require specialist initiation and stabilisation. Ongoing division of responsibility for drug and disease monitoring between specialist and GP by a Shared Care Guideline (SCG). If no SCG in place status reverts to red.  

Green

These medicines are appropriate for initiation in both primary and secondary care. Prescribing is appropriate within licensed or local recommendations.  

Self

Suitable for patient to be directed to buy themselves  

Grey

Not currently used. We intend to include this TLS in future to highlight where a decision to use this medicine is under review.   

Black

Not currently used. We intend to include this TLS in future to highlight where a decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications. Do not prescribe.  

Red Specialist Centre

Not currently used. We intend to include this TLS in future to highlight where this medicine and indication is ONLY available through a Specialist Centre according to a NICE Highly Specialised Technology or NHSE Specialised Commission Circular / Policy.  

netFormulary