North East and North Cumbria
ICS Formulary
 
back
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.

11-08-02 Subfoveal choroidal neovascularisation

Aflibercept 4mg/0.1ml injection Eylea®
Formulary
  • Approved for wet age related macular degeneration in line with NICE.
  • Approved for macular oedema – central retinal vein occlusion in line with NICE.
  • Approved for diabetic macular oedema in line with NICE.
  • Approved for treating visual impairment caused by macular oedema after branch retinal vein occlusion in line with NICE.
  • Approved as an option for treating visual impairment because of myopic choroidal neovascularisation in adults in line with NICE

 

Link  NICE TA 294 Aflibercept solution for injection for treating wet age‑related macular degeneration
Link  NICE TA 305 Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion
Link  NICE TA 346 Aflibercept for treating diabetic macular oedema
Link  NICE TA 409: Aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion
Link  NICE TA 486: Aflibercept for treating choroidal neovascularisation

Red View adult BNF  View SPC online  View childrens BNF  HCD
Brolucizumab Beovu®
Formulary
  • 19.8mg/0.165mL solution for injection (pre-filled syringes)
    • Approved for treating wet age-related macular degeneration in adults in line with NICE
Link  MHRA Drug Safety Update (Jan 2022): Brolucizumab (Beovu▼): risk of intraocular inflammation and retinal vascular occlusion increased with short dosing intervals
Link  NICE TA672: Brolucizumab for treating wet age-related macular degeneration
Link  NICE TA820: Brolucizumab for treating diabetic macular oedema

Red View adult BNF  View SPC online  View childrens BNF  HCD
Faricimab Vabysmo®
Formulary
  • 120mg/1ml solution for injection
    • Approved for the treatment of diabetic macular oedema in adults in line with NICE
    • Approved for the treatment of wet age-related macular degeneration in line with NICE
Link  NICE TA799: Faricimab for treating diabetic macular oedema
Link  NICE TA800: Faricimab for treating wet age-related macular degeneration

Red View adult BNF  View SPC online  View childrens BNF
Ranibizumab 10mg/1ml injection Lucentis®
Formulary
  • Approved for wet age related macular degeneration in line with NICE.
  • Approved for diabetic macular oedema in line with NICE.
  • Approved for visual impairment caused by macular oedema secondary
    to retinal vein occlusion in line with NICE.
  • Approved as a possible treatment for sight problems caused by choroidal neovascularisation in people who also have pathological myopia in line with NICE.

 

 

Link  NICE TA 274 Ranibizumab for treating diabetic macular oedema
Link  NICE TA 155 Ranibizumab and pegaptanib for the treatment of age-related macular degeneration
Link  NICE TA 283 Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion
Link  NICE TA 298 Ranibizumab for treating choroidal neovascularisation associated with pathological myopia

Red View adult BNF  View SPC online  View childrens BNF  HCD
Verteporfin 15mg Injection Visudyne®
Formulary

Approved for photodynamic therapy in wet age-related macular degeneration in line NICE.

Link  NICE NG82: Age-related macular degeneration
Link  NTAG Decision Summary June 2020: Verteporfin

Red View adult BNF  View SPC online  View childrens BNF
Bevacizumab 1.25mg/0.5ml intravitreal injection
Formulary
  • NETAG approved for use in the management of macular oedema
    secondary to retinal vein occlusion. This is considered a more cost
    effective treatment option in RVO compared with ranibizumab.
  • NTAG approved for age related macular degeneration.

 


Red View adult BNF  View SPC online  View childrens BNF