North East and North Cumbria
ICS Formulary
 
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11 Eye

Preservative Free Eye Drops
Microbial contamination of multidose bottles of eye drops can cause eye infections that may lead to damage of the eye and in extreme cases loss of sight. To minimise the risk, multidose bottles of eye drops contain an antimicrobial preservative such as benzalkonium chloride. The preservatives used in eye drops are normally well tolerated, but they are not completely harmless. They can cause irritation and damage to the corneal epithelium. This risk is understood to be greater in patients with pre-existing damage to the ocular surface and where large quantities of preservative containing eye drops are applied repeatedly over a prolonged period (e.g. if applied more than 4 to 6 times daily for several weeks/ months).
To avoid these problems the use of preservative-free eye drops is recommended in:
 Patients who have experienced hypersensitivity reactions or irritation due to preservatives in eye drops.
 Patients who have received corneal grafts.
 Patients with conditions where there is already damage to the ocular surface as a result of disease or trauma, such as dry eye, blepharitis, ocular burns etc.
Treatment with preservative-free eye drops will usually be initiated by an ophthalmologist.

11-03-01 Antibacterials

Chloramphenicol 0.5% eye drops & ointment
First Choice
  • Preservative-free eye drops are also approved for use:
    • 0.5% preservative-free Minims® - first choice.
    • 0.5% preservative-free eye drops unlicensedunlicensed - approved only for patients who are unable to use Minims®due to dexterity problems

Link  MHRA Drug Safety Update (July 2021): Chloramphenicol eye drops containing borax or boric acid buffers: use in children younger than 2 years

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Azithromycin Azyter®
Formulary

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Ciprofloxacin
Formulary

Eye drops: 0.3%
Eye ointment (preservative-free): 0.3%


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Doxycycline
Formulary

SR capsules 40 mg

Specialist indication: drug of choice for ocular rosacea


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Hexamidine
Formulary

UNLICENSED


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Levofloxacin
Formulary

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Moxifloxacin
Formulary

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Polihexanide
Formulary

Unlicensed


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Vancomycin
Formulary

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Fusidic Acid Fucithalmic®
Formulary

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Gentamicin 0.3% ear/eye drops
Formulary
  • 1.5% eye drops with and with out preservative are also approved -  unlicensedunlicensed and Red Traffic Light

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Ofloxacin 0.3% Eye drops
Formulary

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Propamidine Isetionate
Formulary
  • For use in the treatment of acanthamoeba keratitis – used with PHMB.

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Benzylpenicillin 0.3% Eye drops
Formulary

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Cefuroxime 5% eye drops
Formulary

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Erythromycin 0.5% Eye ointment
Formulary

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Gentamicin 15mg/ml
Formulary

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Polyhexamethylene biguinide (PHMB) 0.02% Eye drops
Formulary

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Povidone iodine 5%
Formulary

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