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11. Eye

Some brand names of eye drops have been included in brackets for information, but please always prescribe eye drops generically.

Note: The Northern (NHS) Treatment Advisory Group does not recommend the use of high-dose vitamin and mineral supplements in the prevention of progression of AMD.

Note: The Northern (NHS) Treatment Advisory Group recommends the sequential pharmacological management of MO secondary to RVO as per the North East Retina Group (NERG) RVO treatment pathway.

CD&D APC Patient Decision Aids Resource available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/

CD&D APC “Do Not Prescribe List” and “Grey List – drugs prescribed under limited circumstances” available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/

Chloramphenicol
BNF | BNFC | SPC

Eye drops - 0.5%

Ointment - 1%

Preservative-free = 0.5% preservative-free Minims

Fusidic Acid
BNF | BNFC | SPC

MR Eye Drops - 1% (Fucithalmic)

Gentamicin
BNF | BNFC | SPC

Eye drops - 0.3%

Ofloxacin
BNF | BNFC | SPC

0.3% eye drops

Erythromycin
BNF | BNFC | SPC

0.5% eye ointmentu

Benzylpenicillin
BNF | BNFC | SPC

0.3% eye dropsu

Cefuroxime
BNF | BNFC | SPC

5% eye dropsu

Povidone Iodine
BNF | BNFC | SPC

5% preservative-free eye dropsu

Polyhexamethylene biguinide
BNF | BNFC | SPC

Polyhexamethylene biguinide (PHMB) 0.2% eye dropsu

Aciclovir
BNF | BNFC | SPC

Eye Ointment - 3%

There are currently no licensed topical antifungal agents available for the treatment of eye infections. Products can be obtained as unlicensed medicines to meet specific needs on request from an ophthalmologist or microbiologist.

MHRA Drug Safety Update (Aug 2017): Corticosteroids: rare risk of central serous chorioretinopathy with local as well as systemic administration

Betamethasone sodium phosphate
BNF | BNFC | SPC

Eye Drops - 0.1%

Ointment - 0.1%

Betnesol N
BNF | BNFC | SPC

Eye Drops

Ointment

Dexamethasone
BNF | BNFC | SPC

Eye Drops - 0.1% (Maxidex)

Fluorometholone
BNF | BNFC | SPC

Eye Drops - 0.1%

For use in patients who experience ocular hypertension with other corticosteroids – treatment to be initiated with the advice of an ophthalmologist

Prednisolone
BNF | BNFC | SPC

Eye Drops - 0.5%, 1%, Minims 0.5% (preservative free)

Prednisolone eye drops 0.1%, 0.3%
BNF | BNFC | SPC

Eye drops 0.1%, 0.3%u

Treatment to be initated with the advice of an ophthalmologist.

Prednisolone preservative-free
BNF | BNFC | SPC

0.1%, 0.3%, 0.5% & 1% preservative free eye dropsu

Treatment to be initated with the advice of an ophthalmologist

Maxitrol
BNF | BNFC | SPC

Eye drops

Ointment

Rimexolone
BNF | BNFC | SPC

1% eye drops – for use where Fluorometholone (FML) drops (which are much cheaper) are likely to be insufficiently effective.

To be initiated with the advice of an ophthalmologist.

Fluocinolone acetonide implant
BNF | BNFC | SPC

190 microgram intravitreal implant

NICE TA301

Note: TA301 replaced TA271

Olopatadine
BNF | BNFC | SPC

Eye Drops - 1mg/ml

Sodium cromoglicate
BNF | BNFC | SPC

Drops - 2%

Ortivine-Antistin
BNF | BNFC | SPC

Eye drops containing antazoline sulphate 0.5% + xylometazoline hydrochloride 0.05%

Adalimumab
BNF | BNFC | SPC

40mg injection (prefilled syringe)

Adalimumab is recommended as per NICE TA460 as an option for treating non-infectious uveitis in the posterior segment of the eye in adults with inadequate response to corticosteroids, only if there is:

  • active disease (that is, current inflammation in the eye) and
  • inadequate response or intolerance to immunosuppressants and
  • systemic disease or both eyes are affected (or 1 eye is affected if the second eye has poor visual acuity) and
  • worsening vision with a high risk of blindness (for example, risk of blindness that is similar to that seen in people with macular oedema).
Cyclopentolate Hydrochloride
BNF | BNFC | SPC

Eye Drops - 1%

Ointment - 1%, Minims (preservative free)

Atropine Sulphate
BNF | BNFC | SPC

Eye Drops - 0.5%, 1%; Minims 0.5%,

1% (preservative free) eye drops u

Tropicamide
BNF | BNFC | SPC

0.5% & 1% minims

Phenylephrine
BNF | BNFC | SPC

2.5% eye dropsu and 2.5% minims

The CSM has advised that all beta-blockers including those with cardioselectivity should not be used in patients with asthma or obstructive airways disease unless no other treatment is available. In such cases, the risk of inducing bronchospasm should be appreciated and appropriate precautions taken

Timolol
BNF | BNFC | SPC

Eye Drops - 0.25% & 0.5%

Betaxolol, carteolol and long-acting timolol eye drops are not included in the formulary and should not be used for new patients.

Latanoprost
BNF | BNFC | SPC

Eye Drops - 50 microgram/ml

MHRA Drug Safety Update (July 2015) : Latanoprost (Xalatan): increased reporting of eye irritation since reformulation.

Bimatoprost
BNF | BNFC | SPC

Eye Drops - 300microgram/ml

Latanoprost 50microgram/ml with Timolol 5mg/ml
BNF | BNFC | SPC

Latanoprost 50microgram/ml with Timolol 5mg/ml Eye Drops

For use as a second/third-line agent in patients insufficiently responsive to monotherapy with a prostaglandin analogue or beta blocker.

Ganfort (Bimatoprost 300microgram/ml, Timolol 5mg/ml)
BNF | BNFC | SPC

Eye Drops

For use as a second/third-line agent in patients insufficiently responsive to monotherapy with a prostaglandin analogue or beta blocker

Brimonidine
BNF | BNFC | SPC

Eye Drops - 0.2%

Acetazolamide
BNF | BNFC | SPC

Tablets - 250mg

 

Brinzolamide
BNF | BNFC | SPC

Eye Drops - 10mg/ml

Dorzolamide
BNF | BNFC | SPC

Eye Drops - 2%

Single Use (preservative free) Drops - 2%

Cosopt (Dorzolamide 2%, Timolol 0.5%)
BNF | BNFC | SPC

Eye Drops, Single Use (preservative free)

For use as a second/third-line agent in patients insufficiently responsive to monotherapy with a prostaglandin analogue or beta blocker.

Pilocarpine
BNF | BNFC | SPC

Eye Drops - 0.5%, 1%, 2%, 3%, 4%, 6%

Minims (preservative free) - 2%, 4%

Tetracaine (Amethocaine)
BNF | BNFC | SPC

1% minims eye drops

Oxybuprocaine (Benoxinate)
BNF | BNFC | SPC

0.4% minims eye drops

Proxymetacaine
BNF | BNFC | SPC

0.5% minims eye drops

Proxymetacaine and Fluorescein
BNF | BNFC | SPC

Minims eye drops containing proxymetacaine 0.5% & fluorescein sodium 0.25%

Hypromellose
BNF | BNFC | SPC

Eye Drops 0.3%, 0.5%

First line

Ilube (Acetylcysteine 5%, Hypromellose 0.35%)
BNF | BNFC | SPC

Eye Drops

Second line, opthalmologist advice only

Carbomer 980 0.2% (equivalent to Viscotears)
BNF | BNFC | SPC

Eye Drops

Viscotears Drops - Preservative Free

 

Celluvisc (Carmellose)
BNF | BNFC | SPC

Single Dose Unit (Preservative Free) 0.5%, 1%

Second line, opthalmologist advice only

Lacrilube (Liquid Paraffin, Wool Fat, Yellow Soft Paraffin)
BNF | BNFC | SPC

Eye Ointment

Artifical Tears Minims
BNF | BNFC | SPC
Simple Eye Ointment
BNF | BNFC | SPC
Sodium Chloride
BNF | BNFC | SPC

0.9% eye drops & minims 5% eye drops

5% preservative-free eye drops (PF drops® )u

5% eye ointmentu 

Balanced Salt Solution
BNF | BNFC | SPC

Sterile solution containing sodium chloride 0.64%, sodium acetate 0.39%, sodium citrate 0.17%, calcium chloride 0.048%, magnesium chloride 0.03%, potassium chloride 0.075% in 15ml bottles and 500ml bags -

For intra-ocular or topical irrigation during surgical procedures.

Hydroxypropyl Guar (Systane)
BNF | BNFC | SPC

10ml Multidose bottles
0.8ml Preservative free vials


Contains hydroxypropyl guar, polyethylene glycol 400, propylene glycol (and other ingredients)


Long-acting ocular lubricant used for the treatment of dry eye syndrome. Liquid formulation which turns into a gel on contact with eyes providing fast and long lasting relief. The multidose bottle may be used for up to six months after opening in primary care.
In contact lens wearers, Systane should be applied before inserting lenses and after removal to extend comfortable wearing times.

Ciclosporin eye ointment
BNF | BNFC | SPC

0.2% eye ointmentu

Ciclosporin
BNF | BNFC | SPC

0.1% (1mg/1ml) eye drops (Ikervis®)

For treating 'severe keratitis in adult patients with dry eye disease, which has not improved despite treatment with tear substitutes as per NICE TA369

CD&D APC Ciclosporin 0.1% eye drops (IKERVIS®) INFORMATION FOR PRIMARY CARE leaflet available at: http://medicines.necsu.nhs.uk/guidelines/durham-darlington/

Holoclar
BNF | BNFC | SPC

Ex vivo expanded autologous human corneal epithelial cells containing stem cells.

Holoclar consists of a transparent circular sheet of 300,000 to 1,200,000 viable autologous human corneal epithelial cells (79,000 - 316,000 cells/cm2), including on average 3.5% (0.4 to 16%) limbal stem cells, and stem cell-derived transient amplifying and terminally differentiated cells, attached on a supportive 2.2 cm diameter fibrin layer and maintained in the transport medium

For treating limbal stem cell deficiency after eye burns - See NICE TA467

Fluorescein
BNF | BNFC | SPC

2% minims eye drops, 1mg ophthalmic strips, Fluorets

Diclofenac Sodium
BNF | BNFC | SPC

0.1% eye drops + minims

Specialist initiation only: use for post-operative inflammation limited to patients where corticosteroids are unsuitable.

Ketorolac Trometamol
BNF | BNFC | SPC

0.5% eye drops

Specialist initiation only: use for post-operative inflammation limited to patients where corticosteroids are unsuitable.

Acetylcholine
BNF | BNFC | SPC

20mg in 2ml injection

Apraclonidine
BNF | BNFC | SPC

0.5% & 1% eye drops

Sodium Hyaluronate
BNF | BNFC | SPC

10mg in 1ml bag (Z-Hyalin® , formerly Ophthalin Gelbag ® )

14mg in 1ml syringe (Healon GV® )

Note: The Northern (NHS) Treatment Advisory Group recommends the sequential pharmacological management of MO secondary to RVO as per the North East Retina Group (NERG) RVO treatment pathway.

 

NTAG Nov 2014: The Northern Treatment Advisory Group endorses the previously agreed NETAG decision i.e. that Verteporfin (Visudyne®) PDT is not recommended for use for the treatment of chronic CSCR.

Ranibizumab
BNF | BNFC | SPC

10mg in 1ml injection

NICE TA274, NICE TA155, NICE TA298 , NICE TA283

Note NICE TA237 was replaced by TA274

Bevacizumab
BNF | BNFC | SPC

1.25mg in 0.5ml syringe

See NTAG website for approved and not approved indications http://ntag.nhs.uk/html/eye.php

NTAG Bevacizumab for age related macular degeneration

Aflibercept
BNF | BNFC | SPC

4mg in 0.1ml injection

NICE TA294 - wet AMD

NICE TA305 – Macular oedema

NICE TA346 - diabetic macular oedema

NICE TA409

Dexamethasone Implant
BNF | BNFC | SPC

700 microgram intravitreal implant (Ozurdex)

NICE TA229

NICE TA349

NICE TA460

Note: The Northern (NHS) Treatment Advisory Group recommends the sequential pharmacological management of MO secondary to RVO as per the North East Retina Group (NERG) RVO treatment pathway.

Ocriplasmin▼
BNF | BNFC | SPC

2.5mg/ml concentrate for solution for intravitreal injection

NICE TA297