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 Formulary Chapter 11: Eye - Full Chapter
Notes:
NHS

 

Please contact EKHUFT Medicines Information ext. 7236001 or 01233 616001 with any queries.

Preservative Free formulations should only be prescribed for patients with

  • True preservative allergy i.e. surrounding periorbital skin is either thickened or red or thickened and swelling occurs.
  • Evidence of epithelial toxicity from preservatives
  • Soft contact lenses wearers
  • Long term treatment or frequency > 6 times a daily 
 Details...
11.08.02  Expand sub section  Ocular diagnostic and peri-operative preparations and photodynamic treatment
Absolute Alcohol injection
(Dehydrated alcohol )
View adult BNF View SPC online View childrens BNF
Formulary
Red
unlicensedunlicensed use
Restricted to use by ophthalmology surgeons for corneal debridement 
   
Povidone-Iodine 5% single dose eye drops
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Formulary
Red
Eye drops single dose use 0.5ml
• Ophthalmology use for antisepsis before ocular surgery 
   
11.08.02  Expand sub section  Ocular diagnostic preparations
Fluorescein Sodium (Minims®)
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Formulary
Red
Eye drops 1%, 2% single dose units preservative free 
   
Fluorescein
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Restricted Drug Restricted
Red
Injection 20%
  • Unlicensed Drug Unlicensed
  • fluorescein impregnated strips as Fluorets now discontinued
  • Specialist use only
  • Record patient details, manufactuer, batch no, expiry at administration as per EKHUFT Unlicensed Medicines Policy

     
  •    
    Indocyanine green
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Injection 25mg/5ml
  • Unlicensed Drug Unlicensed
  • Specialist use only  
  •    
    11.08.02  Expand sub section  Ocular peri-operative drugs
    Acetylcholine Chloride (Miochol-E®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    Intraocular irrigation 1% 
       
    Apraclonidine (Iopidine®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Eye drops 0.5%
    Eye drops 1% single dose unit preservative free
  • Specialist use only 
  •    
    Diclofenac Sodium (Voltarol® Ophtha)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Eye drops 0.1% single use preservative free
    Also available as 5ml multidose
  • Specialist use only 
  •    
    Flurbiprofen Sodium (Ocufen®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Eye drops flurbiprofen 0.03% polyvinyl alcohol 1.4%
    single dose units
  • Specialist use only
     
  •    
    Ketorolac Trometamol (Acular®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    Eye drops 0.5%
  • Specialist use only 
  •    
    11.08.02  Expand sub section  Subfoveal choroidal neovascularisation
    Aflibercept (Eylea®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    CCG
    BlueTeq

    Intravitreal injection 40mg in 1ml (0.1ml vial)

    • Specialist use in wet age-related macular degeneration according to NICE TA294
    • Specialist use in treating diabetic macular oedema according to NICE TA346
    • Specialist use in treating visual impairment caused by macular oedema secondary to central retinal vein occlusion according to NICE TA305
    • PBR excluded drug via Blueteq

      Star High cost drug reimbursed separately from NHS England tariff (PBR excluded)







     
    Link  NICE TA294: Aflibercept solution for injection for treating wet age‑related macular degeneration
    Link  NICE TA305: Aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion
    Link  NICE TA346: Aflibercept for treating diabetic macular oedema
       
    Bevacizumab intravitreal injection (Avastin®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    CCG
    BlueTeq

    Unlicensed Product

    Star High cost drug reimbursed separately from NHS England tariff (PBR excluded)

    Only currently funded indication by prospective blu tec application is: Choroidal neovascularisation (CNV) due to causes other than age-related macular degeneration (AMD) or pathological myopia (PM)

    Refer to other policy PR2014-01

     
       
    Ranibizumab (Lucentis®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    CCG
    BlueTeq

    Intravitreal injection 10mg in 1ml (0.3ml vial)

    • Specialist use in age-related macular degeneration according to NICE guideline NICE TA155
    • Currently adopting with commissioners NICE TA274 Specialist use in diabetic macular oedema
    • Specialist use in treating choroidal neovascularisation associated with pathological myopia according to NICE TA298
    • PBR excluded drug via Blueteq

      Star High cost drug reimbursed separately from NHS England tariff (PBR excluded)
     
    Link  NICE TA155: Ranibizumab and pegaptanib for the treatment of age-related macular degeneration
    Link  NICE TA274: Macular oedema (diabetic)
    Link  NICE TA283: Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion
    Link  NICE TA298: Ranibizumab for treating choroidal neovascularisation associated with pathological myopia
       
    Ocriplasmin (Jetrea®)
    View adult BNF View SPC online View childrens BNF
    Formulary
    Red
    High Cost Medicine
    CCG
    BlueTeq

    0.5mg in 0.2ml concentrate for solution for intravitreal injection
    • Use according to NICE TA297
    • PbR excluded drug via Blueteq

    Star High cost drug reimbursed separately from NHS England tariff (PBR excluded)

     
    Link  NICE TA297 Ocriplasmin for treating Vitreomacular Traction
       
    Verteporfin (Visudyne®)
    View adult BNF View SPC online View childrens BNF
    Restricted Drug Restricted
    Red
    High Cost Medicine
    CCG
    BlueTeq


    Only  to be used by prospective BluTec application according to criteria in:

    1. PR 2018-06: Verteporfin (Visudyne®) with photodynamic therapy and/or anti-VEGF therapy for polypoidal choroidal vasculopathy (PCV)
    2. PR 2017-12: Verteporfin (Visudyne®) with photodynamic therapy (PDT) for the treatment of central serous chorioretinopathy (CSCR)
     
       
    11.08.02  Expand sub section  Vitreomacular traction to top
     ....
     Non Formulary Items
    Brilliant Peel®

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Bromfenac  (Yellox®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Nepafenac  (Nevanac®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Pegaptanib Sodium  (Macugen®)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
    Star High cost drug reimbursed separately from NHS England tariff (PBR excluded)
    Link  NICE guidance on pegaptanib in AMD (August 2008)
     
    Rose Bengal  (Minims® Rose Bengal)

    View adult BNF View SPC online View childrens BNF
    Non Formulary
     
    Tear flow test strips

    View adult BNF View SPC online View childrens BNF
    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

    Amber

    Requires to be initiated by specialist for repeat GP Prescribing (Purple as per Eclipse East Kent Primary Care Formulary, may be top sliced) If a downloadable EKPG Prescribing Information Sheet exists in the formulary entry for the drug, it, or an URL (shortcut to webpage/document) should be sent to the GP. See also "Hints in how to incorporate documents for medicines information into clinical communications to GPs".  

    Amber 1

    Shared Care (Orange as per Eclipse East Kent Primary Care Formulary). See the Principles of Shared Care Agreements and Shared Care Agreements: Assessment against agreed Principles of Shared Care documents. If a downloadable template document exists in the formulary entry for this drug, it should be sent to the GP (and patient) once patient specific details are incorporated. See "Hints in how to incorporate shared care documents for medicines into clinical communications to GPs".  

    Amber 2

    Shared Care and topsliced (Orange as per Eclipse East Kent Primary Care Formulary) See the Principles of Shared Care Agreements and Shared Care Agreements: Assessment against agreed Principles of Shared Care documents. If a downloadable template document exists in the formulary entry for this drug, it should be sent to the GP (and patient) once patient specific details are incorporated. See "Hints in how to incorporate shared care documents for medicines into clinical communications to GPs".  

    Black

    A decision has been made by either or both the local or national NHS not to routinely commission this preparation for its licensed indications  

    Blue

    No comment on drug in East Kent Primary Care Formulary (Blue as per Eclipse East Kent Primary Care Formulary)  

    Brown

    Exceptional Use Only (Brown as per Eclipse East Kent Primary Care Formulary)   

    Green

    On East Kent Primary Care Formulary (Pink or Green as per Eclipse East Kent Primary Care Formulary)  

    Grey

    Not assessed/Not recommended (As per Eclipse East Kent Primary Care Formulary)  

    Red

    Hospital Only (As per Eclipse East Kent Primary Care Formulary)  

    RedRed

    Known to be commissioned for local NHS patients but only available to them from another provider than EKHUFT  

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