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.

11-08-02 Ocular peri-operative drugs

Diclofenac
Formulary
  • 0.1% eye drops and unit dose eye drops.
  • For post-operative inflammation limited to patients where corticosteroids are unsuitable.

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Acetylcholine Chloride
Formulary
  • 20mg in 2ml injection.

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Apraclonidine
Formulary
  • 0.5% and 1% ophthalmic solution.

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Ketorolac Acular®
Formulary
  • 0.5% eye drops.

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Nepafenac
Formulary
  • 1 mg/1mL eye drops

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Povidone iodine 5% eye drops
Formulary
  • For use in eye surgery only. 

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Sodium Hyaluronate
Formulary
  • 10mg in 1ml bag (Z-Hyalin®, formerly Ophthalin Gelbag®)
  • 14mg in 1ml syringe (Healon GV®)

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Duovisc® Injection
Formulary
  • Injection for use in cataract surgery containing VisCoat (1% sodium hyaluronate) and ProVisc (3% sodium hyaluronate, 4% chondroitin sulphate).

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Ethanol 20% eye drops.
Formulary
  • For use in the debridement of the corneal epithelium in patients with
    recurrent corneal erosion syndrome.

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