Sterile Compounding
Ophthalmology
When the Standard Eye Drop Isn’t the Right Fit.
Maybe your eyes are sensitive to a preservative or excipient in the standard formulation. Maybe the concentration your child’s prescription calls for isn’t available on the shelf. Maybe your post-op regimen runs four bottles long and staying on schedule is a challenge.
Your eye care provider knows your eye. Voshell’s compounds what they prescribe.
Why Compounding
The Eye Asks for Precision.
Commercial ophthalmic products are formulated for broad clinical use — with preservatives, stabilizers, and pH buffers suited to general populations and extended shelf life.
For patients on chronic therapy, post-surgical patients, pediatric patients, or those with documented sensitivities, the components appropriate for general use may not match the clinical profile of the individual eye.
Compounded ophthalmic preparations are formulated to the components your prescriber specifies — including preservative-free options when your eye care provider determines a preservative-free preparation is appropriate.
Our Ophthalmic Formulary
Sterile Ophthalmic Preparations Voshell’s Compounds.
Cornea and External Disease
The cornea is unforgiving — even small formulation differences can affect tolerability and outcomes. Compounded ophthalmic solutions give prescribers control over concentration, vehicle, and preservative content that commercial products often cannot match.
Available preparations:
- Cyclosporine 0.1%–3% ophthalmic solution (aqueous, MCT/CCT oil, olive oil)
- Cyclosporine/Tacrolimus combination solution
- Acetylcysteine 5%–10% ophthalmic solution — including preservative-free formulations (mucolytic; filamentary keratitis)
- Edetate disodium (EDTA) ophthalmic solutions, multiple concentrations
- Amphotericin B ophthalmic solution
- Voriconazole 1% ophthalmic solution
Antibiotic Compounding
Compounded ophthalmic antibiotics are commonly discussed by prescribers in situations where a specific concentration, combination, or vehicle is required and not commercially available.
Broad-spectrum and targeted antibiotic formulations for bacterial keratitis, post-surgical prophylaxis, and endophthalmitis management, including:
- Tobramycin/Vancomycin combination — broad-spectrum
- Gentamicin ophthalmic solution — gram-negative
- Vancomycin ophthalmic solution and injection — gram-positive coverage
- Amikacin 0.3% — resistant gram-negative organisms
- Cefazolin 50 mg/mL — gram-positive; post-surgical prophylaxis
- Ceftazidime 50 mg/mL — gram-negative; endophthalmitis
- Tobramycin/Vancomycin/Dexamethasone combination solution
Corticosteroid Compounding
For patients on extended courses of topical corticosteroid therapy, post-surgical patients, or patients with documented sensitivities to commercial preservatives, your eye care provider may prescribe a preservative-free preparation. Voshell’s compounds the following ophthalmic solutions in preservative-free vehicles, in the strength your prescriber writes.
Available preparations:
- Dexamethasone sodium phosphate 0.1% — preservative-free
- Prednisolone sodium phosphate 1% — preservative-free
- Methylprednisolone sodium succinate 1% — preservative-free
Glaucoma Compounding
Long-term topical therapy can run for years. When your eye care provider specifies a preservative-free preparation or a custom concentration, Voshell’s compounds the following ophthalmic solutions to specification.
Available preparations:
- Timolol 0.5% ophthalmic solution
- Pilocarpine 0.01%–0.25% ophthalmic solution
- Apraclonidine 0.125% ophthalmic solution
Pediatric Ophthalmic Compounding
Low-dose atropine ophthalmic solution (0.01%–0.05%) — one of the most clinically studied compounded preparations in ophthalmology today. The dosing range allows prescribers to titrate to each patient’s response.
5-Fluorouracil Compounding
5-Fluorouracil at 1% ophthalmic concentration is a compounding-only preparation. There is no commercial product at this strength. Areas of clinical research and prescriber discussion include ocular surface squamous neoplasia (OSSN). Voshell’s compounds 5-Fluorouracil ophthalmic solution under prescription from a licensed eye care provider, prepared under USP <797> sterile standards.
Specialty Single-Compound Preparations
Advanced formulations for complex ocular conditions across multiple specialties:
- Tacrolimus 0.02%–1% ophthalmic oil solution: immunomodulatory; vernal keratoconjunctivitis
- Testosterone 0.05% ophthalmic oil solution: meibomian gland dysfunction and androgen-deficiency dry eye
- Insulin 25 U/mL ophthalmic solution: neurotrophic keratopathy; corneal healing support
- Glutathione 1.25% / Ascorbic Acid 1.25% ophthalmic solution: antioxidant therapy for oxidative stress corneal disease
- DMSO 6.25% ophthalmic solution: penetration enhancer for specialty applications
Delivery Forms Available
Our compounding team can prepare ophthalmic medications in a range of delivery forms to match the clinical need:
- Eye drops (solutions): the most common delivery form for both topical and anti-infective therapy
- Suspensions: for medications that require even distribution of fine particles
- Ophthalmic ointments and gels: for overnight use, dry eye therapy, or conditions requiring prolonged contact time
- Intravitreal preparations: sterile intraocular formulations prepared under strict aseptic conditions (physician-administered)
Our Standards
Our Sterile Compounding Standards
All ophthalmic compounds prepared at Voshell's Pharmacy meet USP <797> sterile compounding standards. As the first accredited sterile compounding pharmacy in Baltimore, we bring a long history of precision and accountability to every ophthalmic preparation.
if a compounded formulation may be right for you
Compliance Note
Compounded ophthalmic medications are prepared based on individual prescriptions from licensed prescribers. All sterile preparations are compounded in compliance with USP <797> standards. Compounded medications are not FDA-approved drug products. They may not be appropriate for all patients or all clinical situations.
