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Bedfordshire and Luton Joint Formulary
Bedfordshire Hospitals NHS Foundation Trust
Bedfordshire, Luton and Milton Keynes ICB
Formulary Chapter: 11 - Eye 
Notes:

Any drug not listed on the Formulary should be considered Non-Formulary - Not recommended for prescribing
11.08.01 Tear deficiency, ocular lubricants, and astringents
BLMK Guidelines for Dry Eye Management

Acetylcysteine 10% eye drops

RED
Restricted Drug Restricted

Filamentary keratitis where 5% acetylcysteine is not effective.

Unlicensed special

 

Entry reviewed: March 2026

BNF BNFc SPC

Acetylcysteine 5% eye drops

Amber SPA
Formulary

Entry reviewed: March 2026

BNF BNFc SPC

Carbomer 0.2%

SELF
Formulary

 Primary care prescribing: Most cost effective brand to be advised via OptimiseRx

Hospital prescribing: brand supplied will depend on availability.

Brands include:

Clinitas (contains preservative),

Evolve (preservative free)

 

Restricted Item Please note preservative free Evolve brand is reserved for patients unable to tolerate preservatives. (Expiry of multidose bottle is 3 months after opening for Evolve brand).

 Entry reviewed: March 2026

 

BNF BNFc SPC
Specific brands of carbomer eye gel: recall of AACARB eye gel, AACOMER eye gel and PUROPTICS eye gel: potential risk of infection

Carboxymethylcellulose, glycerine, Castor oil eye drops

Amber SPA
Formulary

Approved for use in line with BLMK dry eye guidance

 

Brands inclide:

Optive plus

 

Entry reviewed: March 2026

BNF BNFc SPC

Carmellose Sodium 0.5% and 1% eye drops

SELF
Formulary

Second line after hypromellose for use where preservatives are not tolerated

 

Eyeaze Carmellose 0.5% (10ml preservative free bottle) 

Eyeaze Carmellose 1% (10ml preservative free bottle) 

VIZcellose 0.5% (10ml preservative free bottle) 

VIZcellose 1% (10ml preservative free bottle) 

 

 

 

Entry reviewed: March 2026

BNF BNFc SPC

Ciclosporin 1mg/mL Eye drops, emulsion
(For ophthalmology use)

Amber SPA
Restricted Drug Restricted

Restricted - initiation by consultant ophthalmologists in the corneal clinic for the treatment of severe keratitis in adult patients with dry eye disease that has not improved despite treatment with tear substitutes in accordance with NICE TA369.

 

Brands include:

Ikervis

 

Entry reviewed: March 2026

BNF BNFc SPC
NICE TA369: Ciclosporin for treating dry eye disease that has not improved despite treatment with artificial tears

Coenzyme Q10, carboxymethylcellulose (carmellose), poloxamer 407
(Preservative free eye gel/drops)

Amber SPA
Restricted Drug Restricted

For the treatment of moderate to severe dry eyes with corneal staining

For use after complex corneal surgery

 

Drops to be used 2nd line - only where gel is not tolerated

 

Brands include:

VisuXL Gel

VisuXL Drops 

 

Entry reviewed: March 2026

BNF BNFc SPC

Hyaluronic Acid 0.1%, Ectoine 2%, Fucoidan 0.1% and Perilla Extract 0.1% (Xailin ectoine® )

Amber SPA
Formulary

Entry reviewed: March 2026

BNF BNFc SPC

Hypromellose 0.3% eye drops

SELF
Formulary

Self-care - Patients should be advised to purchase a suitable product over the counter for mild/moderate cases.

 

Primary care: Most cost effective brand to be advised via OptimiseRx 

Current 1st line cost-effective brands:  

Aapromel or Aaculose 0.3% or 0.5%

 

 

Entry reviewed: March 2026

BNF BNFc SPC

Liquid Paraffin eye ointment

SELF
Formulary

 

L&D: Lacri-Lube is still unavailable. We are purchasing VitA-POS ointment as a substitute but note this has changed its name to Hylo Night. Prescribe generically on ePMA as 'liquid paraffin eye ointment'.

 

Brands include:

Hylonight

 

Entry reviewed: March 2026

BNF BNFc

Omega-3 essential fatty acids, Vitamins A and D and ultra-filltered phospholipid eye drops

Amber SPA
Restricted Drug Restricted

Restricted: For meibomian gland dysfunction

Approved for use as per BLMK Dry Eye Guidance

 

Brands include: 

VisuEvo

 

Entry reviewed: March 2026

BNF BNFc SPC

Sodium Chloride 5% eye products

GREEN
Formulary

Preservative-free Eye Ointment
Preservative-free eye drops x 10ml

 

For use in in patients with corneal oedema

 

Entry reviewed: May 2023

Sodium Hyaluronate
(0.1%, 0.2%, 0.4% Preservative free eye drops)

SELF
Formulary

For treatment of dry eye

 

 

Brands include:

Eyeaze (contains phosphate buffer)

Hydramed

 

Entry reviewed: March 2026

BNF BNFc SPC
EMA review Questions and answers on the use of phosphates in eye drops Dec 2012

Sodium hyaluronate 0.15% with trehalose 3% carbomer 0.25% eye gel (Thealoz Duo Gel ®)
(Preservative free gel formularion)

SELF
Formulary

 

 

Entry reviewed: March 2026

 

 

BNF BNFc SPC

Sodium hyaluronate 0.15% with trehalose 3% eye drops
(Preservative free eye drops)

SELF
Formulary

For treatment of severe dry eye

 

PRESERVATIVE FREE multidose bottle can be used for up to 3 months after opening

 

Brands include:

Thealoz Duo

 

Entry reviewed: March 2026

BNF BNFc SPC

Sodium Hyaluronate 0.2%, Carbomer 980 and Glycerol eye drops

Amber SPA
Formulary

Approved for use as per BLMK Dry eye guidance

 

Brands include:

Evolve Revive

 

Entry reviewed: March 2026

BNF BNFc SPC

Sodium hyaluronate/trehalose/d-panthenol (Trehapan®)
(Preservative free eye drops)

SELF
Formulary

 

 

Entry reviewed: March 2026

 

 

BNF BNFc SPC
Non formulary items

0.1% Hyaluronic Acid and 2% Dexpanthenol eye drops (Hylo-Care® eye drops)

 
Non Formulary
BNF BNFc SPC

Acetylcysteine 5% with Hypromellose 0.35% (Ilube®)

 
Non Formulary
BNF BNFc SPC

Hydroxyethylcellulose (Minims® Artificial Tears)

 
Non Formulary
BNF BNFc SPC

Hydroxypropyl Guar (Systane®)

 
Non Formulary
BNF BNFc SPC

Hypromellose 0.3% with Dextran 70 0.1% (Tears naturale®)

 
Non Formulary
BNF BNFc SPC

Liquid Paraffin and Liquid Paraffin light eye drops

 
Non Formulary
BNF BNFc SPC

Optive® Fusion

 
Non Formulary
BNF BNFc SPC

Paraffin Yellow Soft

 
Non Formulary
BNF BNFc SPC

Polyvinyl Alchohol 1.4% (Eye Drops )

 
Non Formulary
BNF BNFc SPC

Simple eye ointment

DNP
Non Formulary

Very high cost ~£100 per tube. Do not prescribe.

 

Entry reviewed: August 2025

BNF BNFc SPC

Sodium Chloride 0.9% (Minims® Saline) (Single use, preservative-free)

 
Non Formulary

Removed March 2022 - single use plastic & many other options available

Sodium Hyaluronate (Lubristil®)

 
Non Formulary
BNF BNFc SPC

Sodium Hyaluronate (Vismed® Gel)

 
Non Formulary
BNF BNFc SPC

Sodium Hyaluronate (Vismed® multi)

 
Non Formulary

Sodium Hyaluronate 0.1% and 0.2% eye drop (Hylo-tear® Hylo-Forte®)

 
Non Formulary
BNF BNFc SPC

Soybean oil unit dose eye drops (Emustil®)

 
Non Formulary
BNF BNFc SPC
Classifications
GREEN
May be initiated in any care setting
Amber SPA
Specialist to advise therapy and provide first 28 days supply, continuation in Primary Care
Amber SPIS
Specialist to initiate and stabilise medicine prior to continuation in Primary Care
SCG
To be prescribed as per Shared Care Guidance. If no SCG in place status reverts to red.
RED
Red medicines are designated as specialist only medicines which should only be prescribed by a specialist, usually within secondary care (either due to the requirement for specialist knowledge, long-term monitoring requirements, or restrictions that mean medicine supplies are only available to hospitals).
DNP
A decision has been made either locally and/or nationally not to routinely commission this preparation. Do not prescribe.
SELF
To be purchased over the counter. May be prescribed for chronic, long term conditions or on admission to hospital if essential.