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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...
11.03  Expand sub section  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  Expand sub section  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  Expand sub section  Antifungals
 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  Expand sub section  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

 

 
   
 ....
 Non Formulary Items
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
 
Azithromycin (Azyter)
(ophthalmic)

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

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

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


View adult BNF View SPC online
Non Formulary
 
Foscarnet intravitreal injection


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
 
Polymyxin B Sulphate eye ointment
(Polyfax)

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

View adult BNF View SPC online
Non Formulary
 
Trifluorothymidine eye drops


View adult BNF View SPC online
Non Formulary
 
  
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.  

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