Formulary Chapter 11: Eye - Full Chapter
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Details... |
11.08 |
Miscellaneous ophthalmic preparations |
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Hyaluronidase
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Formulary

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- 1,500unit powder for solution for injection ampoules
- adjunct to local anaesthesia in ophthalmology
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11.08.01 |
Tear deficiency, ocular lubricants, and astringents |
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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.
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Hypromellose
(Ophthalmic drops 0.3%)
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First Choice

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Hypromellose
(Ophthalmic drops Preservative Free)
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First Choice

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- 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
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Carbomer
(Ophthalmic liquid gel)
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First Choice

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Carbomer 980 eye drops
(Ophthalmic liquid gel)
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First Choice

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- 0.2% gel 10g
- Suitable for contact lense wearers
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Carmellose
(Ophthalmic drops)
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First Choice

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- 1% drop 10ml
- VIZcellulose® is the most cost-effective preservative-free carmellose preparation in primary care
- Swindon only - Use Celluvisc SDUs in secondary care.
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Sodium Hyaluronate
(Ophthalmic drops)
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Second Choice

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- 0.2% drops 10ml (Hydramed®)
- 0.4% drops 10ml (Viz-Hyal®)
- Preservative-free
- To be prescribed in line with BSW Dry Eye Guidance.
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Acetylcysteine
(Ophthalmic drops)
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Formulary

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- Acetylcysteine eye drops 5%, hypromellose 0.35% 10ml (includes benzalkonium chloride, disodium edetate)
- Specialist initiation - Only if filamentary keratitis present.
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Carboxymethylcellulose, glycerine & castor oil eye drops
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Formulary

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- Carmellose 0.5ml, glycerol 1%, castor oil 0.25% 10ml
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Ciclosporin
(Ikervis®)
(Ophthalmic drops)
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Formulary

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- 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
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NICE TA369: Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears
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Liquid Paraffin eye ointment
(Lacri-lube®)
(Opthalmic oinment)
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Formulary

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- GWH for recurrent erosions only. Not on formulary at RUH/SFT
- Consider Hylo-night (formerly VitA-POS or Hydramed night)
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Propylene glycol
(Ophthalmic drops)
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Formulary

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Propylene glycol 0.3% and polyethlene glycol 0.4% with hydroxypropyl guar
(Ophthalmic drops)
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Formulary

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Retinol palmitate with soft paraffins
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Formulary

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- 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.
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Sodium Chloride
(Balanced salt solution)
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Formulary

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- Eye irrigation solutions 19ml, 500ml
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Sodium Chloride 0.9%
(Ophthalmic drops)
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Formulary

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Sodium Chloride 0.9%
(Single use ophthalmic drops)
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Formulary

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- 0.9% 0.5ml Preservative-free
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Sodium Chloride 5%
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Formulary

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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
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Sodium Hyaluronate 0.1%, Co-enzyme Q10 0.1%, Vitamin E
(Ophthalmic drops)
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Formulary

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- 0.1% Preservative-free (VisuXL®)
- 2 month expiry
- Specialist initiation only in line with BSW dry eye guidance
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Ciclosporin
(Ophthalmic ointment)
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Unlicensed

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- 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
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Hypromellose 2% in balanced salt solution (HPMC)
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Unlicensed

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11.08.02 |
Ocular diagnostic and peri-operative preparations and photodynamic treatment |
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Acetylcholine
(Intra-ocular irrigation)
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Formulary

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- 20mg powder and solvent for solution for intraocular irrigation
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Apraclonidine
(Single use opthalmic drops)
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Formulary

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Cefuroxime intracameral injection
(Aprokam®)
(injection)
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Formulary

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- 3mg in 0.3ml pre-prepared injection.
- 50mg vial.
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Diclofenac
(Drops)
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Formulary
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 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
 RUH (Single use eye drops 0.1%)
- Non formulary in Salisbury
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Eye topical NSAIDs 3Ts
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Fluorescein
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Formulary

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- 1% and 2% minims
- Ophthalmic strips
- GWH only
- Non formulary at RUH and Salisbury
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Ketorolac
(Drops)
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Formulary

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- 0.5% ophthalmic drops
- Note at GWH - For inflammation requiring extended treatment (up to 21 days) following ocular surgery
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Eye topical NSAIDs - 3TS
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Nepafenac
(Nevanac)
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Formulary

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- Salisbury only
- Non formulary in BaNES and Swindon
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Perflurodecaline
(Heavy Liquid)
(Injection)
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Formulary
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 - GWH - For use in Ophthalmology.
- Non-formulary- SFT & RUH.
- 5ml vial.
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Sodium Hyaluronate
(Pre-filled syringe 1%)
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Formulary

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Tisseel
(RTU Kit)
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Formulary
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 - GWH - For use in Ophthalmology.
- Non-formulary - SFT & RUH
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Mydrane Injection
(0.2 ml solution contains 0.04 mg of tropicamide, 0.62 mg of phenylephrine hydrochloride and 2 mg of lidocaine hydrochloride)
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Restricted

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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)
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11.08.02 |
Subfoveal choroidal neovascularisation |
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Aflibercept
(Eylea®)
(Intravitreal injection)
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Formulary



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NICE TA294: Aflibercept solution for injection for treating wet age‑related macular degeneration
NICE TA305: Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion
NICE TA346: Aflibercept for treating diabetic macular oedema
NICE TA409: Aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion
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Bevacizumab
(Avastin®)
(Intravitreal injection)
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Formulary


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Policy for Bevacizumab for the treatment of rubeotic/neovascular glaucoma and uncontrolled Proliferative Diabetic Retinopathy prior to laser or vitrectomy (adults)
Policy for use of Avastin® (bevacizumab) under the NICE threshold in wet AMD
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Ranibizumab
(Lucentis®)
(Intravitreal injection)
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Formulary



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NICE TA155: Ranibizumab and pegaptanib for the treatment of age-related macular degeneration
NICE TA274: Ranibizumab for treating diabetic macular oedema
NICE TA283:Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion
NICE TA298: Ranibizumab for treating choroidal neovascularisation associated with pathological myopia
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Non Formulary Items |
Acetylcysteine 10% eye drops

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Non Formulary
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Commercial eye hygiene preparations

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Non Formulary
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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
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Hydroxyethylcellulose
(Minims® Artificial Tears)

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Non Formulary
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Idebenone
(Raxone®)

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Non Formulary
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Optive ® Fusion

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Non Formulary
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Paraffin Yellow Soft
(Simple eye ointment)

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Non Formulary
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Pegaptanib Sodium
(Macugen®)

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Non Formulary
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Polyvinyl Alcohol
(Liquifilm Tears or Sno Tears®)

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Non Formulary
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Soybean oil unit dose eye drops
(Emustil®)

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Non Formulary
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Verteporfin
(Visudyne®)
(Injection)

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Non Formulary

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NICE TA68: Photodynamic therapy for age related macular degeneration
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Key |
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Cytotoxic Drug
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Controlled Drug
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High Cost Medicine
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Cancer Drugs Fund
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NHS England |
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Homecare |
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CCG |
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High Cost Drug Approval System |
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Traffic Light Status Information
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