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11.8 Miscellaneous opthalmic preparations

11.8 Miscellaneous opthalmic preparations

11.8.1 Tear deficiency, ocular lubricants and astringents

Lutein and Oral Antioxidants Vitamin Supplements for Eye Conditions - prescribing guidance

Dry Eye Patient Information Leaflet
GREEN* Self-care policy applies - advise patient to purchase where appropriate

GREEN*       Sno-Tears® 1.4% eye drops [Polyvinyl alcohol]
GREEN*      Hypromellose 0.3% eye drops
GREEN*      Clinitas Gel® eye drops [Carbomer]
GREEN*      HYLO-NIGHT® eye ointment (formerly VitA-POS® eye ointment)
GREEN*       Lacri-Lube eye ointment
AMBER       llube® eye drops   
AMBER       Hylo-Forte® eye drops  (Consultant initiation only, reserved for dexterity issues)
                    [Self-care should be considered for mild/moderate dry eye not associated with a co-morbidity]
AMBER       Systane® BALANCE lubricant eye drops (Specialist initiation only for Dry eye  symptoms associated with Meibomian gland 
AMBER       Ciclosporin (Ikervis®) unit dose eye drops - PRESCRIBE BY BRAND
                    Ciclosporin for treatment of dry eye disease that has not improved despite treatment with artificial tears is 
                    recommended as an option by NICE. NICE TA369 
AMBER      Sodium Chloride 5% eye drops
AMBER      Ciclosporin 0.1% eye drops 0.3ml unit dose (Verkazia®)  -- Specialist initiation
RED           Cross Linked Hyaluronic Acid & Co Enzyme Q10 (VisuXL®) Specialist use only 

Severe Dry Eye Only
GREEN*    Evolve HA® eye drops (preservative free) 
                   [Self-care should be considered for mild/moderate dry eye not associated with a co-morbidity]
GREEN*    Xailin HA® (sodium hyaluronate 0.2% Preservative Free)
                   [Self-care should be considered for mild/moderate dry eye not associated with a co-morbidity]
GREEN*    Blink® Intensive Tears** 10ml and 0.4ml unit dose drops [Sodium hyaluronate 0.2%)
                 **[1st line choice hyaluronate in Primary Care]
Access information about the MINOR EYE CONDITIONS SERVICE

11.8.2 Ocular diagnostic and peri-operative preparations and photodynamic treatment 

Ocular diagnostic preparations 
AMBER      Apraclonidine eye drops 0.5%
RED            Fluorescein unit dose eye drops 1%, 2%
RED            Proxymetacaine & fluorescein unit dose eye drops 0.5%
Ocular peri-operative drugs
RED           Balanced Salt Solution® 
AMBER      Diclofenac unit dose eye drops 0.1%
AMBER      Ketorolac eye drops 0.5%
RED           Miochol-E® solution for intra-ocular irrigation
RED           Sodium hyaluronate injection 10mg/ml, 14mg/mL, 23mg/mL
Approved for specific use in ophthalmolgy for volume enhancement of post-enucleation socket syndrome:
RED           Hyaluronic acid injection (Restylane Sub-Q,® Juvederm®) 
Approved for use in opthalmology for those at higher risk of developing post-surgical cystoid macular oedema:
RED          Bromfenac eye drops (Yellox®) 
Subfoveal choroidal neovas cullarisation    
For use as per NICE guidance only. 
RED         Verteporfin injection 15mg vial

Approved for use in line with NICE guidance
NICE TA294     Wet age-related macular degeneration 
NICE TA305     Visual Impairment caused by macular oedema secondary to central retinal vein occlusion
NICE TA346     Treatment for some people with sight problems caused by diabetic macular oedema  
NICE TA486     An option for treating visual impairment because of myopic choroidal  neovascularisation in adults,
                         only if the company provides aflibercept  with the discount agreed in the patient access scheme
RED         Aflibercept  [Eylea 2mg/50microlitres solution for intravitreal injection]                                        (NHS England Commissioned) 
Vitreomacular traction 
Ocriplasmin for use in accordance with NICE guidance as an option in NICE TA297 
RED          Ocriplasmin concentrate for solution for intravitreal injection 2.5mg/mL
                  (Each vial contains 0.5 mg of ocriplasmin in 0.2 ml solution)
Approved for use in accordance with NICE guidance:
NICE TA283      Visual Impairment caused by Macular oedema secondary to retinal vein occlusion
NICE TA274      Diabetic macular oedema (DMO)
NICE TA155      Wet age-related macular degeneration (AMD)
NICE TA298     Choroidal neovascularisation associated with pathological myopia 
RED           Ranibizumab solution for intravitreal injection 10mg/mL vial


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public seeking advice on medicine-related matters are advised to speak with their GP, pharmacist, nurse or contact NHS111 Service
Email: info.elmmb@nhs.net
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