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 Formulary Chapter 11: Eye - Full Chapter
11.01  Administration of drugs to the eye
11.02  Control of microbial contamination
11.03  Anti-infective eye preparations
11.03.01  Antibacterials
Chloramphenicol
(Ophthalmic)
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First Choice
Green 1

0.5% eye drops, 0.5% single use minims, 1% eye ointment

First line for superficial eye infections 

 
Fusidic Acid
(Ophthalmic)
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Second Choice
Green 2

Fucithalmic® Useful for staphylococcal infections

 
   
Gentamicin (ophthalmic)
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Second Choice
Green 2

Gentamicin Sulphate 0.3% & 1.5% eye drops Preservative free eye drops 1.5%

 Effective for infections caused by Pseudomonas aeruginosa

 
   
Gentamicin single use (Minims® Gentamicin Sulphate)
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Second Choice
Green 2

Effective for infections caused by Pseudomonas aeruginosa

 
   
Amikacin
(Ophthalmic)
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Restricted Drug Restricted
Red

Consultant ophthalmologist only. See endophthalmitis protocol

 
   
Ceftazidime
(ophthalmic)
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Restricted Drug Restricted
Red

Consultant ophthalmologist only. See endophthalmitis protocol

 
   
Cefuroxime
(ophthalmic)
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Restricted Drug Restricted
Red

Unlicensed use. (Aprokan) Ophthalmology theatre consultant use only. For prophylaxis of post-operative endophthalmitis in cataract surgery 

 
   
Ciprofloxacin
(Ophthalmic)
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Restricted Drug Restricted
Advice

Restricted: Consultant use only. Effective in infections caused by Pseudomonas aeruginosa. Licensed for corneal ulcers.

 Used off-label for otitis externa

 
   
Moxifloxacin (Moxivig®)
(0.5% PF drops)
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Formulary
Amber

Bacterial keratitis if PF preparation required e.g. frequency more than QDS

 
   
Ofloxacin Eye drops (Exocin®)
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Restricted Drug Restricted
Amber

Restricted: Consultant use only. Effective in infections caused by Pseudomonas aeruginosa. Licensed for corneal ulcers.

 
   
Polymyxin B Sulphate eye ointment (Polyfax®)
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Restricted Drug Restricted
Amber

Effective for infections caused by Pseudomonas aeruginosa

 
   
Propamidine Isetionate (Brolene® eye drops)
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Restricted Drug Restricted
Amber

Specific for acanthamoeba keratitis

 
   
Vancomycin
(ophthalmic)
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Restricted Drug Restricted
Red

Consultant ophthalmologist only. See endophthalmitis protocol

 
   
11.03.02  Antifungals to top
11.03.03  Antivirals
Aciclovir eye ointment 3% (Zovirax®)
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First Choice
Green 1

Prescribe generically for Herpes simplex infections 

 
11.04  Corticosteroids and other anti-inflammatory preparations
11.04.01  Corticosteroids
Betamethasone eye drops
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First Choice
Green 1

Short term treatment of local inflammation

 
Betamethasone eye ointment (Betnesol®)
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First Choice
Green 1

Prescribe generically for short term treatment of local inflammation 

 
Dexamethasone eye drops (Maxidex®)
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First Choice
Green 1

Short term treatment of local inflammation

 
Dexamethasone eye drops single use
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First Choice
Green 1
 
Prednisolone 0.5% eye drops (Predsol)
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First Choice
Green 1
 
Prednisolone Acetate 1% (Pred Forte®)
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First Choice
Green 1
 
Betamethasone 0.1% with Neomycin 0.5% eye drops (Betnesol N®)
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Second Choice
Green 2

Combination products are rarely justified except after surgery to reduce inflammation and prevent infection.

 
   
Bethamethasone with Neomycin (Vista-Methasone-N®)
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Second Choice
Green 2

Prescribe generically. Combination products are rarely justified except after surgery to reduce inflammation and prevent infection.

 
   
Hydrocortisone eye ointment
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Second Choice
Green 2

1% eye ointment and 1% eye drops

 
   
Prednisolone preservative free eye drops
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Second Choice
Green 2

0.1%, 0.3%, 0.5% & 1%

see specials guidance

 
Link  Specials Guidance
   
Dexamethasone intravitreal implant (Ozurdex®)
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Restricted Drug Restricted
Red
High Cost Medicine

Ophthalmology Consultant use in macular oedema NICE TA229

 
Link  NICE TA349: Diabetic Macular Oedema
   
Dexamethasone with Antibacterials (eye) (Sofradex®)
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Formulary
Green 2

Combination products are rarely justified except after surgery to reduce inflammation and prevent infection

 
   
Dexamethasone with Neomycin and Polymyxin B sulphate (Maxitrol®)
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Formulary
Green 2

Combination products are rarely justified except after surgery to reduce inflammation and prevent infection

 
   
Fluorometholone (FML®)
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Restricted Drug Restricted
Amber

Useful when prednisolone 0.5% is not available

 
   
Prednisolone 0.5% with Neomycin 0.5% (Predsol-N®)
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Formulary
Green 2

Combination products are rarely justified except after surgery to reduce inflammation and prevent infection

 
   
11.04.02  Other anti-inflammatory preparations
Adalimumab  (Humira®)
(Ophthalmology)
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Restricted Drug Restricted
Red
High Cost Medicine

 Injectable preparation not suitable for primary care prescribing

 
   
Antazoline 0.5% with Xylometazoline 0.05% (Otrivine-Antistin®)
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Restricted Drug Restricted
Amber

Allergic conjunctivitis. Use with caution in patients susceptible to angle closure glaucoma

 
   
Azelastine (Optilast®)
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Restricted Drug Restricted
Amber
 
   
Sodium Cromoglicate
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Formulary
Green 1

Allergic conjunctivitis and seasonal keratoconjunctivitis

 
   
11.05  Mydriatics and cycloplegics to top
11.05  Antimuscarinics
Atropine
(eye)
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First Choice
Green 1

1% eye drop and 1% eye ointment

Action up to seven days

 
Atropine Sulphate single use (Minims® Atropine Sulphate)
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First Choice
Green 1

Action up to seven days

 
Cyclopentolate
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First Choice
Green 1

Cyclopentolate eye drops 0.5% and 1%

Action up to 24 hours

 
Cyclopentolate Hydrochloride single use (Minims® Cyclopentolate Hydrochloride)
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First Choice
Green 1

Action up to 24 hours

 
Tropicamide (Mydriacyl®)
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First Choice
Green 1

Action 4-6 hours

 
Tropicamide single use (Minims® Tropicamide)
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First Choice
Green 1

Action 4-6 hours

 
Homatropine
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Second Choice
Green 2

1% eye drops, 2% eye drops and 2% single use minims

Action up to three days

 
   
11.05  Sympathomimetics
Phenylephrine Hydrochloride (Minims® Phenylephrine Hydrochloride )
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First Choice
Green 1

Action up to 5-7 hours

May interact with systemically administered monoamine oxidase inhibitors MAOIs

 
Phenylephrine Hydrochloride
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Restricted Drug Restricted
Red

10% single use minims

Contraindicated in children and the elderly due to the risk of systemic side effects May interact with systemically administered monoamine oxidase inhibitors MAOIs

 
   
11.06  Treatment of glaucoma
11.06  Beta-blockers
Timolol 0.25%
(eye drops)
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First Choice
Green 1

MHRA advise that beta blockers should not be used in patients with asthma or a history of obstructive airways disease unless no alternative treatment is available

 
Betaxolol (Betoptic®)
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Second Choice
Green 2

Single dose preservative free 0.25% eye drops second line

(Timolol PF is temporarily unavailable from the manufacturers)

 
   
11.06  Prostaglandin analogues to top
Latanoprost
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First Choice
Green 1

Prostaglandin analogues can cause changes in eye colouration and irritation

 
Bimatoprost (Lumigan®)
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Second Choice
Advice

Prescribe generically

Prostaglandin analogues can cause changes in eye colouration and irritation

0.01% eye drops second line when first line prostaglandin are not tolerated

Preservative free preparations are reserved for patients with proven sensitivity to benzalkonium chloride.

Bimatoprost single dose eye drops 0.03% first line preservative free 

 
   
Travoprost
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Second Choice
Green 2

Prescribe generically.

Prostaglandin analogues can cause changes in eye colouration and irritation

Second line when first line prostaglandin are not tolerated

 
   
Bimatoprost with Timolol (Ganfort®)
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Restricted Drug Restricted
Amber
 
   
Latanoprost 0.005% with Timolol 0.5% (Xalacom®)
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Formulary
Green 2
 
   
Tafluprost (Preservative Free) 15micrograms/ml (Saflutan®)
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Restricted Drug Restricted
Amber

Prostaglandin analogues can cause changes in eye colouration and irritation

Preservative free preparations are reserved for patients with proven sensitivity to benzalkonium chloride.

Tafluprost only for patients intolerant to bimatoprost

 
   
Travoprost with Timolol (DuoTrav®)
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Formulary
Green 1
 
   
11.06  Sympathomimetics
Brimonidine Tartrate (Alphagan®)
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Formulary
Green 2

Contraindicated with monoamine oxidase inhibitor (MAOI) therapy and patients on antidepressants which affect noradrenergic transmission (e.g. tricyclic antidepressants and mianserin). Allergy and irritation

 
   
Brimonidine Tartrate 0.2% with Timolol 0.5% (Combigan®)
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Restricted Drug Restricted
Amber
 
   
11.06  Carbonic anhydrase inhibitors and systemic drugs
Acetazolamide (Diamox®)
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Restricted Drug Restricted
Amber
 
   
Acetazolamide oral liquid
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Restricted Drug Restricted
Amber
 
   
Brinzolamide (Azopt®)
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Formulary
Green 2

Allergy and irritation

 
   
Dorzolomide 2% with Timolol 0.5% (Cosopt®)
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Restricted Drug Restricted
Amber
 
   
11.06  Miotics
Pilocarpine
(eye drops)
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Restricted Drug Restricted
Red

Blurred vision can affect the performance of skilled tasks especially at night

Required as part of Acute Glaucoma protoco

 
   
Pilocarpine preservative free
(eye drops)
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Restricted Drug Restricted
Red

Blurred vision can affect the performance of skilled tasks especially at night

Required as part of Acute Glaucoma protoco

 
   
11.07  Local anaesthetics
Lidocaine 4% with Fluorescein 0.25% (Minims®)
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Formulary
Green
 
   
Oxybuprocaine (Minims® )
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Restricted Drug Restricted
Red
 
   
Proxymetacaine (Minims®)
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Formulary
Green
 
   
Tetracaine (Minims® Amethocaine)
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Formulary
Green
 
   
11.08  Miscellaneous ophthalmic preparations to top
11.08.01  Tear deficiency, ocular lubricants, and astringents
Acetylcysteine 5% eye drops
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Restricted Drug Restricted
Red

Mucolytic or filamentary keratitis. Initiation limited to consultant based on slit lamp findings of adherent mucin. Repeat prescription should only be determined by this examination.

 
   
Acetylcysteine 5% with Hypromellose 0.35% (Ilube®)
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Restricted Drug Restricted
Amber

Mucolytic or filamentary keratitis. Initiation limited to consultant based on slit lamp findings of adherent mucin. Repeat prescription should only be determined by this examination.

 
   
Carbomers
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Formulary
Green 2

First line alternative to hypromellose.

Clinitas Gel (Carbomer 180 10g). Prescribe by brand in primary care / FP10 

 

 
   
Carbomers (Viscotears®)
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Formulary
Advice

Preservative free single use 30x0.6ml

First line alternative to hypromellose where preservative free required

Prescribe by brand in primary care / FP10

Gel - Diagnostic aid in ophthalmology (contact lens coupling agent) 

 
   
Carmellose
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Formulary
Green 2

Evolve Carmellose 0.5% PF 10ml or Celluvisc® 1% carmellose 1% single dose UDV

Second line alternative if hypromellose & carbomer ineffective. Prescribe by brand in primary care / FP10

Evolve carmellose PF have a 90 day expiry from first opening and are preservative free.

Reserve single use unit dose preparations for patients who do not experience relief with Evolve carmellose 0.5 PF%

 
   
Hypromellose
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Formulary
Green 1

First line eye lubricant. Compliance is an important factor in successful treatment outcome.

Hypromellose 0.3% preserved & preservative free: prescribe as Evolve Hypromellose 0.3% PF 10ml.

Evolve hypromellose PF have a 90 day expiry from first opening and are preservative free 

 
   
Liquid Paraffin eye ointment (Xailin Night®)
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Formulary
Green

For night time use.

Contains no preservative.

Prescribe by brand in primary care / FP10 

 
   
Polyvinyl Alchohol (SnoTears®)
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Formulary
Green 2

First line alternative to hypromellose

Safe for contact lens wearers

 
   
Polyvinyl Alcohol (Liquifilm Tears or Sno Tears®)
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Formulary
Green 2

Liquifilm Tears UDV first line alternative to hypromellose where preservative free required

Safe for contact lens wearers 

 
   
Sodium Chloride
(Balanced salt solution)
Restricted Drug Restricted
Amber
 
   
Sodium Chloride (Minims® Saline)
Restricted Drug Restricted
Amber
 
   
Sodium Chloride 0.9% Solutions
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Restricted Drug Restricted
Amber
 
   
11.08.02  Ocular diagnostic and peri-operative preparations and photodynamic treatment
11.08.02  Ocular diagnostic preparations
Fluorescein Sodium
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Formulary
Green

Minims

 
   
Indocyanine green
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Restricted Drug Restricted
Red

Approved for use in ophthalmology, where it is used as a diagnostic aid.

 
   
11.08.02  Ocular peri-operative drugs
Acetylcholine Chloride (Miochol-E®)
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Restricted Drug Restricted
Red
 
   
Diclofenac (Voltarol® Ophtha)
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Restricted Drug Restricted
Red

Single use drops

 
   
Ketorolac (Acular®)
(Eye)
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Restricted Drug Restricted
Red

Macular Oedema. Continued for one month post operatively

 
   
Nepafenac  (Nevanac®)
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Formulary
Red

Hospital Only: postop macular oedema in patients with diabetes only

 
   
11.08.02  Subfoveal choroidal neovascularisation to top
Bevacizumab intravitreal injection (Avastin®)
View adult BNF View SPC online View childrens BNF
Restricted Drug Restricted
Red

Unlicensed use for neovascular rubeotic glaucoma in Ophthalmology only.

For other indications discuss with CCG on an individual patient basis.

 
   
Ranibizumab (Lucentis®)
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Restricted Drug Restricted
Red
High Cost Medicine

Ophthalmology only in line with NICE guidance TA155 and TA274

 
   
11.08.02  Vitreomacular traction
11.09  Contact lenses
11.99.99.99  Miscellaneous
11.99.99.99  Antifungals
11.99.99.99  Cytotoxics / wound healing modulators to top
11.99.99.99  Fibrinolytic drugs
11.99.99.99  Glues - ocular
11.99.99.99  Immunosuppressants
Ciclosporin
(Eye)
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Restricted Drug Restricted
Red Amber

For atopic keratoconjunctivitis sicca (dry eye) when conventional therapies have failed

0.1% drops (Ikervis): initiated by ophthalmology - AMBER

Ointment: Unlicensed. Not suitable for Primary Care prescribing - RED

 

 
Link  NICE TA369 - Ciclosporin for treating eye disease that has not improved despite treatment with artificial tears
   
11.99.99.99  Treatment of burns
11.99.99.99  Visco-elastics to top
11.99.99.99  Other
 ....
 Non Formulary Items
Acetylcysteine

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Non Formulary
 
Acetylcysteine 10% eye drops

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Non Formulary
 
Aflibercept  (Eylea®)

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Non Formulary
High Cost Medicine
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
 
Alteplase intravitreal injection

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Non Formulary
 
Amo Complete

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Non Formulary
 
Amphotericin (eyedrops)

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Non Formulary
 
Amphotericin (intravitreal)

Non Formulary
 
Apraclonidine  (Iopidine®)

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Non Formulary
 
Azithromycin  (Azyter®)
(ophthalmic)

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Non Formulary
 
Benzylpenicillin
(ophthalmic)

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Non Formulary
 
Bethamethasone  (Vista-Methasone®)

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Non Formulary
 
Boston Advance Cleaner

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Non Formulary
 
Boston Advance Conditioning Solution

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Non Formulary
 
Brilliant Peel ®

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Non Formulary
 
Brinzolamide 1% with Timolol 0.5%  (Azarga®)

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Non Formulary
 
Brinzolamide 10mg/ml & brimonidine 2mg/ml  (Simbrinza®)

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Non Formulary
 
Brinzolamide with timolol  (Azarga®)

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Non Formulary
 
Bromfenac  (Yellox®)

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Non Formulary
 
Carbomer 980 eye drops

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Non Formulary
 
Carbomers  (Liposic®)

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Non Formulary
 
Carbomers  (liquivisc®)

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Non Formulary
 
Carboxymethylcellulose, glycerine & castor oil eye drops  (Optive Plus®)

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Non Formulary
 
Carmellose Sodium  (Carmize®)

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Non Formulary
 
Carteolol  (Teoptic®)

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Non Formulary
 
Chloramphenicol  (Chloromycetin®)

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Non Formulary
 
Chlorhexidine
(ophthalmic)

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Non Formulary
 
Chlortetracycline
(ophthalmic)

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Non Formulary
 
Controlled Drug  Cocaine

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Non Formulary
 
Dexamethasone with Antibacterials  (Tobradex®)

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Non Formulary
 
Diclofenac Sodium  (Voltarol® Ophtha multidose)

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Non Formulary
 
Dipivefrine Hydrochloride  (Propine®)

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Non Formulary
 
Disodium Edetate 0.37%

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Non Formulary
 
Dorzolomide  (Trusopt®)

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Non Formulary
 
Econazole 1% eye drops

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Non Formulary
 
Emedastine  (Emadine®)

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Non Formulary
 
Epinastine  (Relestat®)

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Non Formulary
 
Erythromycin
(ophthalmic)

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Non Formulary
 
Fluocinolone intravitreal implant  (Iluvien®)

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Non Formulary
High Cost Medicine
 
Fluorescein  (Anatera®)

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Non Formulary
 
Cytotoxic Drug  Fluorouracil

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Non Formulary
 
Flurbiprofen Sodium  (Ocufen®)

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Non Formulary
 
Foscarnet intravitreal injection

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Non Formulary
 
Ganciclovir 0.15% ophthalmic gel  (Virgan®)

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Non Formulary
 
Ganciclovir intravitreal injection

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Non Formulary
 
Gentamicin  (Genticin®)

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Non Formulary
 
Glycerol (glycerin)
(eye drops)

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Non Formulary
 
Hyaluronidase  (Hyalase®)

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Non Formulary
 
Hydrocortisone Acetate with Neomycin  (Neo-Cortef®)

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

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

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Non Formulary
 
Hypromellose  (Isopto Alkaline®)

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Non Formulary
 
Hypromellose  (Isopto Plain®)

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Non Formulary
 
Hypromellose 0.3% with Dextran 70 0.1%  (Tears naturale®)

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Non Formulary
 
Hypromellose single use

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Non Formulary
 
Idebenone  (Raxone®)

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Non Formulary
 
Ketotifen  (Zaditen®)

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Non Formulary
 
Latanoprost  (Xalatan®)

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Non Formulary

Prescribe generically

 
Levobunolol

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Non Formulary
 
Levobunolol  (Betagan®)

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Non Formulary
 
Levofloxacin
(ophthalmic)

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Non Formulary
 
Liquid Paraffin and Liquid Paraffin light eye drops

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Non Formulary
 
Liquid Paraffin eye ointment

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Non Formulary
 
Liquid Paraffin eye ointment

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Non Formulary
 
Lodoxamide  (Alomide®)

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Non Formulary
 
Loteprednol  (Lotemax®)

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Non Formulary
 
Cytotoxic Drug  Methotrexate
(Eye)

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Non Formulary
 
Methotrexate
(Uveitis)

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Non Formulary
 
Metipranolol  (Minims® Metipranolol)

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Non Formulary
 
Miconazole 1% eye drops

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Non Formulary
 
Cytotoxic Drug  Mitomycin
(eyes)

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Non Formulary
 
Neodocromil  (Rapitil®)

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Non Formulary
 
Neomycin Eye drops

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Non Formulary
 
Nepafenac  (Nevanac)

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Non Formulary
 
Ocriplasmin  (Jetrea®)

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Non Formulary
High Cost Medicine
 
Olopatadine  (Opatanol®)

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Non Formulary
 
Optive ® Fusion

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Non Formulary
 
Oxysept 1 Step

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Non Formulary
 
Paraffin Yellow Soft
(Simple eye ointment)

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Non Formulary
 
Pegaptanib Sodium  (Macugen®)

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Non Formulary
High Cost Medicine
 
Phenylephrine & ketorolac  (Omidria®)

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Non Formulary
 
Phenylephrine Hydrochloride  (Mydriasert®)

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Non Formulary
 
Pilocaprine long acting  (Pilogel®)

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Non Formulary
 
Polihexanide
(eye drops)

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Non Formulary
 
Potassium Ascorbate (Ascorbic acid)
(eye drops)

Non Formulary
 
Povidone iodine 5%
(ophthalmic)

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Non Formulary
 
Proxymetacaine 0.5% with Fluorescein Sodium 0.25%  (Minims®)

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Non Formulary
 
Retinol palmitate with soft paraffins  (VitA-POS®)

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Non Formulary
 
Rimexolone  (Vexol®)

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Non Formulary
 
Rose Bengal  (Minims® Rose Bengal)

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Non Formulary
 
Saline Solution

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Non Formulary
 
Sodium Chloride 5% eye products

Non Formulary
 
Sodium Citrate
(eye drops)

Non Formulary
 
Sodium Cromoglicate  (Opticrom®)
(Preservative Free )

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Non Formulary
 
Sodium cromoglicate preservative free

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Non Formulary
 
Sodium Hyaluronate

Non Formulary
 
Sodium Hyaluronate  (Hylo-Forte®)

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Non Formulary

Prescribe Evolve HA in Primary Care / on FP10

Evolve HA PF have a 90 day expiry from first opening and are preservative free

Third line alternative if first and second line treatments fail

 
Sodium Hyaluronate  (Hylo-Tear®)

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Non Formulary

Prescribe Evolve HA in Primary Care / on FP10

Evolve HA PF have a 90 day expiry from first opening and are preservative free

Third line alternative if first and second line treatments fail

 
Sodium Hyaluronate  (Lubristil®)

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Non Formulary

Prescribe Evolve HA in Primary Care / on FP10

Evolve HA PF have a 90 day expiry from first opening and are preservative free

Third line alternative if first and second line treatments fail

 
Sodium Hyaluronate  (Vismed® Gel)

View adult BNF View SPC online View childrens BNF
Non Formulary

Prescribe Evolve HA in Primary Care / on FP10

Evolve HA PF have a 90 day expiry from first opening and are preservative free

Third line alternative if first and second line treatments fail

 
Sodium Hyaluronate  (Vismed® multi)

Non Formulary

Prescribe Evolve HA in Primary Care / on FP10

Evolve HA PF have a 90 day expiry from first opening and are preservative free

Third line alternative if first and second line treatments fail

 
Sodium Hyaluronate with Lidocaine

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

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Non Formulary
 
Tafluprost and Timolol  (Taptiqom®)

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Non Formulary
 
Timolol Once-daily
(eye drops)

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Non Formulary
 
Timolol Once-daily  (Nyogel®)

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Non Formulary
 
Tissue Adhesive  (Histacryl®)

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Non Formulary
 
Total Care Daily Cleaner

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Non Formulary
 
Total Care Disinfecting and Wetting Solution

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Non Formulary
 
Trifluorothymidine eye drops

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Non Formulary
 
Verteporfin  (Visudyne®)

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Non Formulary
High Cost Medicine
Link  NICE TA68: Photodynamic therapy for age related macular degeneration
 
Viscoat Viscoelastic

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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 children's 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

Traffic Light Status Information

Status Description

Green

Suitable for use in primary care  

Amber

Specialist initiation. Shared care in place  

Red

Red do not use..  

Advice

Some formulations restricted  

Black

NICE "Do not do"  

Green 1

1st line option  

Green 2

2nd line option  

Green 3

3rd line option only  

Not Recomended / Black

Low Value Medicine not recommended for use - see NHSE guidelines  

OTC

This preparation should be bought over the counter for self-care  

Red Amber

Check product description for traffic light status  

Red Black

Low Value Medicine  

netFormulary