Greater Glasgow and Clyde Medicines
Key to symbols The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP The medicine should only be used and prescribed by a specialist Indicates the preferred choice within a class or group of medicines
The medicine should be initiated by, or on the advice of a specialist, but is suitable for continuation by a GP
The medicine should only be used and prescribed by a specialist
Indicates the preferred choice within a class or group of medicines
11. Eye

11.8. Miscellaneous ophthalmic preparations

Total Formulary
Specialist Only
ADALIMUMAB (injection)

Restrictions:

Use of adalimumab for the treatment of non-infectious uveitis is restricted to specialist use in accordance with NICE TA460.

Prescribing Notes:

Adalimumab should be prescribed by brand name. Amgevita® is the preferred biosimilar.

For the use in other indications, see sections 1.5.3, 10.1.3 and 13.5.3

BNF Link

Total Formulary
Specialist Only
IDEBENONE (tablets)

Restrictions:

The treatment of visual impairment in adolescents and adults with Leber's Hereditary Optic Neuropathy (LHON) is restricted to use only by consultant neuro-ophthalmologists in patients with LHON who are not yet blind (i.e. they do not meet the UK criteria to be registered as severely sight-impaired).

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11.8.1. Tear deficiency, ocular lubricants, and astringents

Patients with chronic dry eye conditions should be educated that long-term and regular use of eye lubricants is recommended to achieve maximum benefit. Many of the preparations for dry eyes are considered to be medical devices rather than medicines. The preparations listed in this section are all included in Part 3 of the Scottish Drug Tariff (Appliances) and are able to be prescribed on a GP10 prescription.
Preferred List
Preferred List First Line
CLINITAS GEL (EYE DROPS)

Prescribing Notes:

  • Clinitas gel is considered the first line treatment for dry eye conditions. 
  • Contains carbomer 980 0.2% as the active ingredient. 
  • Preservatives: cetrimide, sodium edetate.

BNF Link

Xailin Night (eye ointment)

Prescribing Notes:

  • Contains white soft paraffin, white mineral oil and lanolin alcohols. 
  • Preservatives: preservative-free.

BNF Link

LUMECARE (eye gel)

Prescribing Notes:

  • Contains carbomer 0.2%. 
  • Preservatives: cetrimide, disodium edetate

BNF Link

Hylo-Night (VITA-POS) (eye ointment)

Prescribing Notes:

  • Hylo-Night is the preferred paraffin-based preparation and until recently was known as VITA-POS.
  • The recommended frequency is once daily at night.
  • Contains retinol palmitate 250units/g, liquid paraffin and wool fat. 
  • Preservatives: preservative-free.

BNF Link

Total Formulary
BLINK INTENSIVE TEARS (Eye drops)

Restrictions:

Restricted to use in severe dry eyes only.

Prescribing Notes:

  • Considered the first line sodium hyaluronate preparation.
  • Contains sodium hyaluronate 0.2%, polyethylene glycol 0.25%. 
  • Preservatives: borax, boric acid.

BNF Link

Specialist and GP
CICLOSPORIN (IKERVIS) (eye drops)

Restrictions:

Restricted to initiation by consultant ophthalmologists for the treatment of severe keratitis in adults with dry eye disease which has not improved despite treatment with tear substitutes.

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SYSTANE BALANCE (EYE DROPS)

Restrictions:

Restricted to use in severe dry eyes only.

Prescribing Notes:

  • Do not use more than four times daily
  • Contains polyglycol 0.3% and polyethylene glycol 400 0.4%
  • Preservatives: boric acid, disodium edetate

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EVOLVE HA (eye drops)

Restrictions:

Restricted to use in severe dry eyes only.

Prescribing Notes:

  • Contains sodium hyaluronate 0.2%
  • Preservatives: borax, boric acid

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CELLUVISC (0.5% eye drops)

Restrictions:

Restricted to use in severe dry eyes only.

Prescribing Notes:

  • Single dose units contain carmellose sodium 0.5%. 
  • Preservatives: preservative-free.

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EVOLVE CARMELLOSE (eye drops)

Restrictions:

Restricted to use in severe dry eyes only.

Prescribing Notes:

  • Contains carmellose sodium 0.5%
  • Preservatives: boric acid

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HYLO-FORTE (eye drops)

Restrictions:

Restricted to use in severe dry eye only. 

Prescribing Notes:

  • This preparation should only be considered for patients with dexterity problems and for whom this administration system is suitable. 
  • Contains sodium hyaluronate 0.2%. 
  • Preservatives: preservative-free.

BNF Link

Specialist and GP
ILUBE (Eye drops)

Restrictions:

Restricted to initiation by specialist for use in severe dry eyes only.

Prescribing Notes:

  • Contains acetylcysteine 5% and hypromellose 0.35%
  • Preservatives: benzalkonium chloride, disodium edetate

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HYPROMELLOSE (eye drops)

Restrictions:

Excludes single dose unit preparations.

Prescribing Notes:

Use for short-term management of simple dry-eye. Other treatment options may be more appropriate for chronic dry eyes. 

Contains hypromellose 0.3%. Preservatives may include benzalkonium chloride. 

BNF Link

11.8.2. Ocular diagnostic and peri-operative preparations and photodynamic treatment

Total Formulary
Specialist Only
BROLUCIZUMAB (BEOVU) (injection)

Restrictions:

Restricted to specialist use in accordance with local protocol for the treatment of adults with neovascular (wet) age-related macular degeneration (AMD).

BNF Link

Specialist Only
NEPAFENAC (3mg/ml eye drops)

Restrictions:

Restricted to specialist use for reduction in the risk of postoperative macular oedema associated with cataract surgery in diabetic patients.

Prescribing Notes:

Nepafenac 3mg/mL eye drops provide a once daily alternative to nepafenac 1mg/mL eye drops (administered three times daily). 

The use of nepafenac 3mg/ml eye drops is not recommended by SMC for use for postoperative pain and inflammation associated with cataract surgery and remains non-formulary.

BNF Link

Specialist and GP
APRACLONIDINE (eye drops)

Restrictions: Restricted to specialist initiation for the diagnosis of Hornor’s syndrome and post-laser surgery.

Prescribing Notes:

For use in the management of glaucoma, see section 11.6.7

BNF Link

Specialist Only
OCRIPLASMIN (JETREA) (intravitreal injection)

Restrictions: Restricted to use only by Vitreo-retinal Surgeons in patients who are unfit for surgery who have either vitreomacular traction plus macular hole, regardless of whether they have epiretinal membrane formation, or vitreomacular traction alone (no epiretinal membrane and no macular hole).

BNF Link

Specialist Only
AFLIBERCEPT (EYLEA) (intravitreal injection)

Restrictions: Restricted to specialist use for indications detailed under Prescribing Notes.

Prescribing Notes:

Formulary indications are:

  • Use in adults for the treatment of neovascular (wet) age-related macular degeneration. 
  • Treatment of visual impairment due to macular oedema secondary to central retinal vein occlusion in accordance with NHSGGC protocol. 
  • Treatment of visual impairment due to macular oedema secondary to branch retinal vein occlusion (protocol in development)
  • Treatment of visual impairment due to diabetic macular oedema (DMO) in adults.  It is restricted to specialist use for the treatment of visual impairment due to DMO in adults with best corrected visual acuity (BCVA) 75 Early Treatment Diabetic Retinopathy Study (ETDRS) letters or less at baseline. 
  • Treatment of visual impairment due to myopic choroidal neovascularisation (myopic CNV) in line with national guidance.

BNF Link

Specialist and GP
NEPAFENAC (1mg/ ml eye drops)

Restrictions:

the reduction of postoperative macular oedema associated with cataract surgery in diabetic patients is restricted to specialist initiation in diabetic patients with retinopathy.

Prescribing Notes:

Initial supply should be obtained from the specialist centre with GP prescribing only necessary where the specialist considers extending the course of treatment to a total duration of 60 days.

For the relevant SMC advice click here

BNF Link

Specialist Only
Sodium hyaluronate (Intra-ocular injection)
Specialist Only
RANIBIZUMAB (intravitreal injection)

Restrictions:

Ranibizumab is restricted to specialist use in accordance with local protocols for the following indications:

  • The treatment of neovascular (wet) age-related macular degeneration (AMD)
  • The treatment of visual impairment due to diabetic macular oedema (DME)
  • The treatment of visual impairment due to macular oedema secondary to retinal vein occlusion (branch RVO or central RVO)
  • The treatment for visual impairment due to choroidal neovascularisation secondary to pathologic myopia

NHSGGC Protocols for the Formulary inidcations can be accessed here (NHS network access required)

Prescribing Notes:

Ranibizumab is not recommended by SMC and is therefore non-Formulary for the following indication:

  • Treatment of proliferative diabetic retinopathy in adults (non-Submission to SMC)

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Specialist Only
VERTEPORFIN

Restrictions: Restricted to specialist use only.

BNF Link

Specialist Only
MIOCHOL

Restrictions: Restricted to specialist use only.

BNF Link

Specialist and GP
KETOROLAC (0.5% eye drops)

Restrictions:

Restricted to intitiation by or on the advice of a specialist.

Prescribing Notes:

Duration of treatment to be advised by the specialist, but should not exceed three weeks post-operatively

BNF Link

Specialist Only
FLURBIPROFEN

Restrictions: Restricted to specialist use only.

BNF Link

DICLOFENAC (eye drops)
FLUORESCEIN