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Before the 1950s, when Allergan and Alcon began marketing and widely distributing prescription ophthalmic drops, almost all ophthalmic drops were compounded. That has all changed as commercially available drugs for ophthalmic use has exploded in recent years. But for many patients with unique ophthalmic needs, commercial products are just not suitable.

At times, the demand for a particular drug outpaces its availability. Sometimes patients can't tolerate the commercial products, usually due to the preservatives. Commercially available antibiotic ophthalmic products are often not concentrated or strong enough to treat a severe infection. Some compounded antibiotic ophthalmic preparations (topicals and intraocular injections) are prepared from commercially available injections, but the stability of the drug in the solution or vehicle may only be 14 days refrigerated. For these and many other situations, a custom compounded pharmaceutical is an important option.

How can compounds help?

Compounded eye medications can be prepared to treat a variety of eye conditions such as infections caused either by bacteria, a fungus, or a virus. Compounded medications can also be used to treat glaucoma, age-related macular degeneration (AMD), and ulcers. Your pharmacist can also compound preparations to dilate the pupil or serve as anesthesia for certain eye procedures.

Your compounding pharmacist can work with you and your prescriber to customize a medication to meet your specific ophthalmic needs. 

Preparation Examples:

  • Combination antimicrobial drops
  • Combination glaucoma drops
  • Treatment for dry eye disease
  • Cataract formulations
  • Cyclosporine Ophthalmic drops for both animals and humans
  • Phenylephrine Ophthalmic drops
  • Preservative-free preparations that are not commercially available
  • Preparations to remove ingredients that are not tolerated by the patient
  • Acetylcysteine 5% and 10% Ophthalmic Drops
  • Atropine 0.01% Ophthalmic Drops
  • Cefazolin 50mg/ml Ophthalmic Drops
  • Ceftazidime 50mg/ml Ophthalmic Drops
  • Fortified Tobramycin 14mg/ml and 15mg/ml Ophthalmic Drops
  • Fortified Vancomycin 25mg/ml and 50mg/ml Ophthalmic Drops
  • Cyclosporine (Preservative-Free)  0.5%, 1% and 2% Ophthalmic Drops
  • Dexamethasone (Preservative-Free) 0.025%, 0.05% and 0.1% Ophthalmic Drops
  • EDTA 1%, 2%, and 3% Ophthalmic Drops
  • Progesterone 0.05%/ Testosterone 0.05% Ophthalmic Drops
  • Tretinoin 0.01% Ophthalmic Drops and Ophthalmic Ointment

Customized ophthalmic preparations are sterile, free from foreign particles, and compounded specifically for instillation into the eye. To ensure the quality and safety of these compounds, sterile preparations are made in a cleanroom and laminar flow isolator that meets or exceeds each of the standards set by the United States Pharmacopeia (USP) chapter 797.

September 24, 2014
Reviewed by
Managing Editor