Ophthalmology

Ophthalmology Specialist formulary list

**Other indications for particular drugs may be included on completion of further specialist lists**

For information on use of unlicensed medicines or medicines used 'off-label' - click here

The following medicines are approved for prescribing by or on the recommendation of a prescribing ophthalmology specialist:

TAF SECTION	MEDICINE	SUMMARY OF RESTRICTED INDICATION	CATEGORY	PROTOCOL
11.3.1	Ciprofloxacin 0.3% eye drops	Corneal ulcers
	Gentamicin 0.3% eye drops	Corneal ulcers
	Cefuroxime 5% eye drops (preservative free) (unlicensed)	Corneal ulcers
11.3.2	Amphoteracin 0.15% eye drops (preservative free) (unlicensed) Available from Moorfields	Fungal keratitis		The challenge of fungal keratitis. Br J Ophthalmol Dec 2011; 95(12): 1623-1624.
11.3.2	Miconazole 1% eye drops (preservative free) (unlicensed) Available from Moorfields	Fungal keratitis
11.3.3	Aciclovir 3% eye ointment	Viral keratitis
11.3.3	Ganciclovir 0.15% eye gel	Viral keratitis. Restricted to use in cases of resistance to aciclovir
11.3.4	Propamidine isethanoate 0.1% eye drops	Acanthamoeba keratitis. First line in combination with chlorhexidine digluconate 0.02% eye drops		Acanthamoeba Keratitis: Diagnosis and Treatment Update 2009. Am J Ophthalmol Oct 2009; 148(4): 487-499.
	Chlorhexidine digluconate 0.02% eye drops (preservative free) (unlicensed) Available from Moorfields	Acanthamoeba keratitis. First line in combination with propamidine isethanoate 0.1% eye drops
	Hexamidine 0.1% eye drops (unlicensed) Available from IDIS	Acanthamoeba keratitis. Second line in combination with polihexanide 0.02% eye drops
	Polihexanide 0.02% eye drops (preservative free) (unlicensed) Available from Moorfields	Acanthamoeba keratitis. Second line in combination with hexamidine 0.1% eye drops
11.4	Prednisolone acetate 1% eye drops	Idiopathic uveitis, post-operative keratitis, scleritis
	Dexamethsone 0.1% eye drops/ Minims^® dexamethasone sodium phosphate 0.1% (preservative free)	Idiopathic uveitis, post-operative keratitis, scleritis
	Betamethasone sodium phosphate 0.1% eye/ear and nose drops	Idiopathic uveitis, post-operative keratitis, scleritis
	Prednisolone sodium phosphate 0.5%/Minims^® prednisolone sodium phosphate 0.5% (preservative free)	Idiopathic uveitis, post-operative keratitis, scleritis
	Fluorometholone 0.1% eye drops	Idiopathic uveitis, post-operative keratitis, scleritis
11.5	Cyclopentolate 0.5%, 1% eye drops	Anterior and posterior uveitis (if associated with signs of anterior uveitis)
11.5	Atropine 0.5%, 1% eye drops	Iridocyclitis and anterior uveitis
11.6	Latanoprost 50micrograms/mL eye drops▼	Reduction of IOP in patients with open angle glaucoma and ocular hypertension.		NICE CG 85
	Latanoprost 50micrograms/mL with timolol (as maleate) 0.5% eye drops	Reduction of IOP in patients with open angle glaucoma and ocular hypertension when both drugs are indicated.
	Bimatoprost 100micrograms/mL eye drops	Reduction of IOP in patients with open angle glaucoma and ocular hypertension. Alternative to latanoprost not requiring refrigeration.
	Latanoprost 50micrograms/mL single use eye drops	Reduction of intra ocular pressure (IOP) in patients with open angle glaucoma and ocular hypertension who require a benzalkonium chloride free preparation.
	Bimatoprost 300micrograms/mL with timolol (as maleate) 0.5% single dose eye drops	Reduction of IOP in patients with open angle glaucoma and ocular hypertension when both drugs are indicated. Restricted to patients who cannot tolerate preservative.		Note: Bimatoprost with timolol standard eye drops are non-formulary.
	Timolol 0.25%, 0.5% eye drops and 0.25%, 0.5% long acting eye drops	Reduction of IOP in primary open angle glaucoma.
	Dorzolamide 2% eye drops	Reduction of IOP in those resistant to, or unable to take beta-blockers in open angle glaucoma or pseudoexfoliative glaucoma.
	Dorzolamide 2% with timolol 0.5% eye drops	Reduction of IOP in patients with open-angle glaucoma or pseudoexfoliative glaucoma when topical beta-blocker monotherapy is not sufficient.
	Brinzolamide 10mg/mL eye drops	Reduction of IOP in patients with open angle glaucoma and ocular hypertension who are unresponsive to beta‑blockers or in those whom beta‑blockers are contraindicated, or as adjunctive therapy to beta‑blockers or prostaglandin analogues. Alternative to dorzolamide when dorzolamide causes intolerable stinging.
	Brinzolamide 10mg/mL with timolol 5mg/mL eye drops▼	Reduction of IOP in patients with open-angle glaucoma or ocular hypertension for whom monotherapy provides insufficient IOP reduction. Alternative to dorzolamide and timolol when dorzolamide and timolol causes intolerable stinging.
	Acetazolamide SR tablets	Reduction of IOP in open angle glaucoma and secondary glaucoma.
	Acetazolamide IV injection	Reduction of IOP in acute angle-closure glaucoma.
	Brimonidine 0.2% eye drops	Reduction of IOP in patients with open angle glaucoma or ocular hypertension as an adjunct to beta blockers, or alone in those unresponsive to beta-blockers, or if beta-blockers are contra-indicated.
	Brimonidine 0.2% with timolol 0.5% eye drops	Reduction of IOP in patients with chronic open-angle glaucoma or ocular hypertension who are insufficiently responsive to topical beta-blockers.
	Pilocarpine 1%, 2%,4% eye drops	Reduction of IOP in acute angle-closure glaucoma and some secondary glaucoma.
11.8.1	Ciclosporin 2% eye drops (preservative free) (unlicensed) Available from Moorfields	Relief of severe dry eye symptoms associated with chronic ocular inflammation.		Topical ciclosporin in the treatment of ocular surface disorders. Br J Ophthalmol 2005; 89: 1363-1367. Clinical review: topical ophthalmic use of cyclosporin A. Ocul Immunol Inflamm 2010; 18(5): 352-61.
	Acetylcysteine 5%, hypromellose 0.35% (Ilube^®) eye drops	Relief of dry eye symptoms associated with impaired or abnormal mucus production.
	Sodium chloride 4.5% eye drops (unlicensed) Available from Tayside Pharmaceuticals	Corneal oedema.
11.8.2	Ketorolac 0.5% eye drops	Reduction of post-operative inflammation and associated pain. (unlicensed: off-label dose).
	Flurbiprofen 0.03% with polyvinyl alcohol 1.4% eye drops	Maintenance of dilation during surgery, prevention and treatment of cystoid macular oedema and post-operative cataract complications.
	Nepafenac 1mg/mL eye drops	Reduction of the risk of post-operative macular oedema associated with cataract surgery in diabetic patients with diabetic retinopathy.
	5-Fluorouracil	Prevention of scarring post glaucoma surgery (unlicensed).		Moorfields Safe Surgery System Guidelines for Trabeculectomy
	Mitomycin C	Prevention of scarring post glaucoma surgery (unlicensed).		Moorfields Safe Surgery System Guidelines for Trabeculectomy
	Ranibizumab▼	Treatment of visual impairment due to diabetic macular oedema restricted to use in those with best corrected visual acuity (BCVA) 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline.
	Ranibizumab▼	Treatment of visual impairment due to macular oedema (MO) secondary to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO) in adults.
	Ranibizumab▼	Treatment for visual impairment due to choroidal neovascularisation secondary to pathologic myopia in adults.
	Ranibizumab▼	Treatment of neovascular (wet) age-related macular degeneration (AMD).		NICE MTA 155 May 2012 Royal College of Ophthalmologists Ranibizumab: The Clinician's Guide to commencing, continuing and discontinuing treatment Royal College of Ophthalmologists. Age-Related Macular Degeneration 2009 Guidelines for Management-Update Royal College of Ophthalmologists AMD consent form
	Aflibercept 40mg/mL (0.1mL)▼(Eylea^®)	Treatment of visual impairment due to macular oedema (MO) secondary to central retinal vein occlusion (CRVO) in adults. 2^nd line choice (in patients commenced treatment elsewhere).
	Aflibercept 40mg/mL (0.1mL)▼(Eylea®)	Treatment of neovascular (wet) age-related macular degeneration (AMD) as an alternative to ranibizumab.

	May be prescribed by Hospital Specialists only
	May be prescribed in General Practice under the direction of a Specialist