What conditions may require fortified eye drops?

Resistant microbial keratitis (an emergency that can progress rapidly and cause permanent vision loss; around 30,000 cases occur in the U.S. annually), corneal ulcers, and bacterial infections on the ocular surface.

What conditions are intravitreal injections used for, and what drug classes are used?

Age-related macular degeneration (AMD), diabetic retinopathy, retinal vein occlusion, and endophthalmitis (intravitreal antibiotics are used to help prevent loss of vision). Drug classes include steroids, antibiotics, and antifungals.

Ophthalmic Compounding & Eye Medications | Town & Country Compounding

Compounded Ophthalmic Medications

Atropine 0.01% ophthalmic solution 10 mL droptainer bottle

Atropine Eye Drops (Low-Dose, Pediatric / Myopia)

The strength of eye drops needed for children with myopia is not commercially available. A compounding pharmacist can use the higher-strength commercial product and dilute it for the pediatric patient. This is done only in a sterile compounding lab.

Town & Country Compounding compounds various strengths of atropine eye drops for children or adults with myopia (nearsightedness) and other conditions. With recent stability data, our compounded Atropine 0.01% can now be dispensed in a 10 mL droptainer bottle that no longer requires refrigeration or overnight shipping on ice, providing at least a 90-day supply. This medication requires a prescription.

Video guide · Atropine — John Herr, RPh

Autologous Serum Eye Drops (ASED)

Autologous serum eye drops are often requested when patients have not had success with various medications for chronic dry eyes. Their own serum is used to make their eye drops. Because the drops are made from the patient's own blood, no preservatives or chemical additives are required.

Pharmacist holding compounded sterile antibiotic eye drop vials

Fortified Antibiotic Eye Drops

Eye drops are often needed at a higher strength than what is commercially available for certain conditions and therefore must be prepared by a compounding pharmacy. Often, the alternative to fortified ophthalmic drops is hospitalization and intravenous infusions. It is important to get these eye drops to the patient very quickly when needed.

Topical Losartan (Ophthalmic)

Losartan is only commercially available in tablet form; there is no ophthalmic form available. Commercial tablets may not be used to compound a sterile product. Only experienced, high-quality compounding pharmacies should compound topical losartan for the eye.

Video guide · Topical Losartan — Viral Jani, PharmD, RPh

Topical Losartan ophthalmic solution bottle being held

Intravitreal Injections

Intravitreal injections allow medication to be administered in the space behind the eye called the vitreous cavity. The procedure takes place in a clinic, surgery center, or hospital, and any compounded medications that may be needed are prepared by our pharmacy with a prescription for each specific patient.

Used for several types of conditions:

Age-related macular degeneration (AMD)
Diabetic retinopathy
Retinal vein occlusion
Endophthalmitis infection

Formulations we prepare include:

Phenylephrine / tropicamide / ofloxacin / tetracaine / flurbiprofen syringes (P10) — or custom combinations
Lidocaine / epinephrine / BSS (Shugarcaine) syringes or vials

Classes of drugs often used in intravitreal injections:

Steroids · Antibiotics · Antifungals

Pharmacist in purple gloves preparing sterile syringes for intravitreal injection in a cleanroom hood

Chronic, Severe Dry Eyes: Exploring Sterile Autologous Serum Eye Drop Medication

Health prescribers often turn to autologous serum eye drops — a unique, natural option made from a patient's own serum — when standard therapies haven't relieved chronic dry eye.

Advancements in Addressing Chronic or Severe Dry Eyes

New therapies and compounded options are giving patients with chronic or severe dry eyes more durable relief.

Ophthalmic Compounding

Sterile Compounding Labs for Eye Medications

Compounded Ophthalmic Medications