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 Formulary Chapter 11: Eye - Full Chapter
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11.08.01  Expand sub section  Tear deficiency, ocular lubricants, and astringents
 note 

See Dry eye pathway before prescribing


Preservative free for mild to moderate dry eyes – consider preservative-free formulations for patients with:-

·         True preservative allergy to 1st/2nd/3rd line treatment options

·         Evidence of epithelial toxicity from preservatives

·         Patients on large numbers of drops a day to prevent epithelial toxicity

High risk patients e.g. corneal graft
Carbomer '980' 0.2% eye drops (GelTears Ophthalmic Gel®)
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Third Choice
Green

OTC Patients should be advised to purchase if appropriate.

Eye Gel

  • Dry Eye
  • Adults and Children:1 drop into affected eye(s) three or four times daily.
 
Link  Dry Eye Pathway
   
Carbomer '980' 0.2% eye drops 0.6ml unit dose preservative free (Viscotears®)
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Third Choice
Green

OTC Patients should be advised to purchase if appropriate.

Eye Gel

Adults:1 drop into affected eye(s) three to four times daily

Children:Not recommended.

 
   
Carbomer '980' 0.2% eye drops 0.6ml unit dose preservative free (Viscotears®)
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Third Choice
Green

OTC Patients should be advised to purchase if appropriate.

Indication : Dry eye(s)

Carbomer '980' 0.2% eye drops 0.6ml unit dose preservative free

Adults: One drop into affected eye(s) 3 to 4 times daily

Children:Not recommended.

 
   
Sodium Hyaluronate 0.2% (Hylo-Forte®)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops preservative free

  • 6 month expiry
 
Link  Dry Eye Pathway
   
Carmellose 1% & 0.5% (Celluvisc®)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops (single dose) preservative free

 

 
Link  Dry Eye Pathway
   
Carmellose Sodium 0.5% (Optive®)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops

  • Contains purite, which turns to tears in eye (6 month expiry)
 
Link  Dry Eye Pathway
   
Hyaluronic Acid 0.1% (Hylo-Tear®)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops preservative free

  • 6 month expiry
 
Link  Dry Eye Pathway
   
Hypromellose 0.5% (Isopto Plain®)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops

  • Dry eye. Lubrication for artificial eyes.
 
   
Hypromellose 0.3%
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops

  • Excipients depend on brand
 
Link  Dry Eye Pathway
   
Hypromellose 0.3% eye drops preservative free (Tear-Lac®)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops preservative free

  • 6 month expiry
 
Link  Dry Eye Pathway
   
Sodium Chloride 5%
(Ophthalmic)
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Formulary
Blue

Eye Drops 5% and Eye ointment 5%

Eye Drops 5% preservative free
Prescribe as ODM5®
Preservative free
Multi-dose easy to use bottle
In-use life 90 days from opening

Red Eye drops (single use) 0.9%. 
   
Sodium Hyaluronate 0.15%, Trehalose 3% eye drops® (Thealoz Duo)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops

  • Sodium Hyaluronate 0.15%, trehalose 3% 10ml
  • For SEVERE dry eyes
  • Adults and Children:1 drop into affected eye(s) 4—6 times daily.
  • Product is stable for 3 months once opened so does not need to be prescribed every month
 
   
Sodium Hyaluronate 0.2% (Blink Intensive Tears®)
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Formulary
Green

OTC Patients should be advised to purchase if appropriate.

Eye Drops

    Adults and Children: 1 or 2 drops into affected eye(s) as required.  
   
Systane Balance®
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Formulary
Blue

OTC Patients should be advised to purchase if appropriate.

Eye Drops

  • For patients with Meibomian Glandular Disease (MGD)
 
   
Acetylcysteine 10%
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Formulary
Blue
unlicensedunlicensed Special without preservatives for patients with filaments 
   
Acetylcysteine 5%  (Ilube®)
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Formulary
Blue

Indication : Dry eye due to deficient tear and mucous secretion

Contains benzalkonium chloride and sodium edetate

10ml bottle with dropper

Adults & Children : One or Two drops into affected eye(s) 3 or 4 times Daily

 
   
 ....
 Non Formulary Items
Blephaclean®
(Blephaclean or similar sterile eye wipes)

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Non Formulary
Black
Blephaclean and other similar sterile eye wipes are available to purchase over the counter (OTC) at local pharmacies, without restrictions.

Please refer to the BNF or contact the Medicines Management Team by email on hsccg.medicines-management@nhs.net if you
are unsure of a product’s status.


Link  Brighton Joint Formulary Not for routine prescribing (BLACK list)
Link  Conditions for which ACBS products can be prescribed
Link  NICE 09/2012 - Management of blepharitis
Link  Not to be Prescribed List
 
Carbomers  (GelTears®)

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Non Formulary
 
Carbomers  (liquivisc®)

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Non Formulary
 
Carbomers  (Viscotears®)

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Non Formulary
 
Hydroxyethylcellulose  (Minims® Artificial Tears)

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Non Formulary
 
Hypromellose  (Isopto Alkaline®)

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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  (Artelac® SDU)

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Non Formulary
 
Lacri-Lube®  (Liquid Paraffin)

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Non Formulary

Eye Ointment
There is an MHRA recall on specific batches of Lacrilube. Stocks are likely to be affected until Q1 2016.
Link  Dry Eye Pathway
Link  MHRA Medical Safety Alert - Lacri-Lube Eye Ointment - small black particles on or around the nozzle of the tube
 
Liquid Paraffin  (Lubi-Tears®)

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Non Formulary
 
Polyvinyl Alchohol  (SnoTears®)

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

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Non Formulary
 
Povidone  (Oculotect®)

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Non Formulary
 
Sodium Hyaluronate  (Lubristil®)

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Non Formulary
 
Sodium Hyaluronate  (Vismed® Gel)

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Non Formulary
 
Sodium Hyaluronate  (Vismed® multi)

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

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Non Formulary
 
Zinc Sulphate

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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
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

Black

Comment : Not to be routinely commissioned (prescribed) in any care setting (primary or secondary care). This may be due to a lack of good clinical evidence, cost effectiveness, concerns over safety or due to the availability of more suitable alternatives. As such, drugs classified as Black should be considered as non-formulary.   

Red

Initiation : Specialist only
Repeat Prescribing : Specialist
Monitoring : Specialist
Comment : Prescribing must be in line with any specific treatment criteria outlined. In exceptional circumstances a GP may be asked to prescribe – the specialist must provide adequate information and support.   

Amber

Initiation : Specialist only
Repeat Prescribing : Primary care OR specialist
Monitoring : Primary care OR specialist
Comment : Monitoring according to Effective Shared Care Agreement (ESCA) for stabilised patients only. GP agreement should be requested by specialist and confirmed/declined by GP on a patient-by-patient basis.   

Blue

Initiation/Recommendation : Specialist only
Repeat Prescribing : Primary care
Monitoring : Primary care
Comment : Should be initiated or recommended by a specialist. Monitoring of either medicine or disease does not require specialist skills or equipment   

Green

Initiation : Primary care or specialist
Repeat Prescribing : Primary care
Monitoring : Primary care
Comment : Suitable for non specialist initiation   

OTC

Patients should be advised to purchase if approriate.  

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