Ganciclovir Ophthalmic Gel 0.15%

How it works

Ganciclovir is phosphorylated within virus-infected cells and the active triphosphate inhibits viral DNA polymerase, halting replication of herpes simplex virus on the ocular surface; the gel vehicle prolongs corneal contact.

Prescribing in practice

• Treatment should continue for a short period after the corneal epithelium has healed, and topical corticosteroids should be avoided in active epithelial (dendritic) herpetic keratitis as they can worsen the infection.
• Soft contact lenses should not be worn during treatment of active herpetic keratitis.
• Transient blurring and mild local irritation or stinging after application are common.

Monitoring

Monitoring is by serial slit-lamp examination to confirm healing of the dendritic ulcer and to detect any progression or stromal involvement requiring specialist input.

Counselling the patient

• Vision may blur for a short time after applying the gel, so wait before driving.
• Do not wear contact lenses until the infection has cleared and you are advised it is safe.
• Keep using it for the full course, including the days after the eye feels better, and return promptly if vision worsens.

Evidence & guidelines

Topical ganciclovir gel is an established treatment for herpes simplex epithelial keratitis and is widely used as an alternative to aciclovir eye ointment in ophthalmic practice.