Corneal infection

The regional formulary will not cover all eventualities for infections medicines choices. As with any condition; patient specific factors and sensitivities need to be considered. Please consider this regional formulary advice alongside any relevant local Board guidelines.

For general guidance on administration of drugs to the eye and on control of microbial contamination of eye drops, please see the ‘General information on eye drops’ recommendations.

NICE CKS: Herpes simplex - ocular

Refer all cases of suspected ocular herpes simplex infection to Eye Casualty or an emergency eye service for same-day assessment and specialist management. Do not initiate drug treatment while awaiting specialist ophthalmology assessment.

Apply 5 times a day until healing complete, then apply 3 times a day for a further 7 days, treatment does not usually exceed 21 days.

200mg 5 times daily for 7 days (increase to 400mg 5 times daily if immunocompromised). 400mg twice daily maintenance dose to prevent recurrence.

Prescribing Notes:

NICE CKS guidance on ocular herpes simplex advises referring all cases of suspected ocular herpes simplex infection to Eye Casualty or an emergency eye service for same-day assessment and specialist management. Do not initiate drug treatment while awaiting specialist ophthalmology assessment.
Treat with ganciclovir eye gel with or without oral aciclovir. Oral aciclovir is used where the ophthalmologist notes deeper ocular involvement or recurrent HSV infections.
During treatment with ganciclovir women of childbearing age should use effective contraception and men with partners of childbearing age should be advised to use barrier contraception during and for at least 6 months after treatment.

History Notes

30/07/2026

Regional formulary chapter launched.