Chloramphenicol Eye Drops and Eye Ointment: Uses, Dosage and Side Effects

Chloramphenicol is one of the most widely prescribed antibiotic eye medicines in India. You may have been handed a small bottle of drops, a tube of ointment, or a strip of single-use capsules, and sent home with brief instructions.

This guide explains what the medicine does, how it is normally used, what side effects to watch for, and just as importantly, when it is not the right treatment.

Key takeaway

Chloramphenicol eye drops are a broad-spectrum antibiotic used to treat bacterial infections of the eye surface, most commonly bacterial conjunctivitis. In India they are a prescription-only (Schedule H) medicine. They are usually used for about five days, work only against bacteria, and should not be used for viral or allergic eye problems.

What are chloramphenicol eye drops?

Chloramphenicol eye drops are an antibiotic (a medicine that acts against bacteria) applied directly to the surface of the eye. In India the drops are usually supplied as a 0.5% w/v solution in a small dropper bottle. The same antibiotic is also made as a 1% eye ointment.

You may see it sold under brand names such as Chlorocol or Chloromycetin, as well as under its generic name. All of these contain the same active ingredient.

How chloramphenicol works

Chloramphenicol is bacteriostatic, which means it stops bacteria from multiplying rather than killing them outright. It does this by attaching to part of the bacterial cell’s protein-making machinery, so the bacteria cannot build the proteins they need to grow. Your own immune system then clears the weakened infection.

Because chloramphenicol is a small, fat-soluble molecule, it passes reasonably well into the tissues at the front of the eye.

What are chloramphenicol eye drops used for?

Chloramphenicol is used for surface infections of the eye infections of the conjunctiva (the clear membrane covering the white of the eye and the inner eyelids) and sometimes the cornea (the clear window at the front of the eye).

Common reasons a doctor may prescribe it include:

• Bacterial conjunctivitis, the most frequent use, typically with redness, gritty discomfort and sticky yellow or green discharge that glues the lashes together in the morning
• Blepharitis: inflammation and crusting along the eyelid margins
• Certain superficial corneal infections, when the ophthalmologist judges it appropriate
• Prevention of infection in some specific situations, at a doctor’s discretion

It is effective against a broad range of common eye bacteria, including Staphylococcus aureus, streptococci (including Streptococcus pneumoniae), Escherichia coli, Haemophilus influenzae, Klebsiella and Enterobacter species, Moraxella and Neisseria species.

If you are unsure whether your symptoms fit this picture, our guide to types of conjunctivitis and how they differ explains how bacterial, viral and allergic pink eye present differently.

Infections chloramphenicol does not treat

This is the part most patients are never told, and it matters.

• Viral conjunctivitis (eye flu). Antibiotics have no effect on viruses. Most contagious “pink eye” outbreaks in India are viral.
• Allergic conjunctivitis. Itching is the hallmark of allergy, not infection. Antibiotic drops will not help and may irritate further.
• Fungal eye infections. These need antifungal treatment and are relatively common in India after injury with vegetable matter.
• Pseudomonas aeruginosa and Serratia marcescens. The Indian product label states plainly that chloramphenicol does not provide adequate cover against these organisms. This is clinically important, because Pseudomonas is the bacterium most often behind contact-lens-related corneal infections, an infection that can damage sight within days.

This last point is the strongest reason not to reach for leftover chloramphenicol if you are a contact lens wearer with a painful red eye. A painful eye in a lens wearer needs examination for a possible corneal ulcer (keratitis), not a guess at treatment.

Can you buy chloramphenicol eye drops without a prescription in India?

No. Chloramphenicol is listed under Schedule H of the Drugs and Cosmetics Rules in India, which means it cannot legally be sold without a prescription from a registered medical practitioner.

This differs from some other countries. In the United Kingdom, for example, chloramphenicol eye drops can be bought directly from a pharmacist for adults and older children. Indian readers who come across UK health pages online sometimes assume the same applies here. It does not.

The prescription requirement is not bureaucracy. Chloramphenicol carries a small but genuine risk of blood-related side effects, and using it for the wrong condition delays the correct diagnosis.

Does every red eye need antibiotic drops?

No, and this is worth saying clearly, because it runs against the usual expectation.

The American Academy of Ophthalmology’s Conjunctivitis Preferred Practice Pattern notes that mild bacterial conjunctivitis is likely to be self-limited, that indiscriminate use of topical antibiotics should be avoided, and that no evidence shows one topical antibiotic to be superior to another.

In practice, an ophthalmologist may still prescribe antibiotic drops to shorten symptoms, reduce the risk of spread, or allow a return to work or school sooner. That is a reasonable judgement made after examining the eye. What it is not is a reason to start antibiotics on your own for every red eye, which contributes to antibiotic resistance and can mask a more serious problem.

If you want to understand what else may be prescribed, our overview of eye drops used for conjunctivitis covers the main categories.

Chloramphenicol eye drops dosage

Follow the dose written on your prescription. Published schedules vary widely because the right frequency depends on how severe the infection is and which form you have been given.

Commonly used regimens include:

• Eye drops: one to two drops into the affected eye, every two to six hours depending on severity. Severe infections are often treated more frequently for the first 48 hours, then tapered.
• Eye ointment (1%): a small amount inside the lower lid, roughly every three hours initially, often reducing to three or four times a day.
• A common combination: drops during the day and ointment at bedtime. Ointment stays on the eye surface longer and works overnight, while drops do not blur daytime vision.

Only treat the eye or eyes your doctor has told you to treat. If only one eye is infected, treating both can spread the infection.

How long should you use chloramphenicol eye drops?

Most courses run for about five days. Some product labels allow up to seven days, and doctors often advise continuing for around 48 hours after the eye looks and feels normal, so the infection does not rebound.

Two rules matter more than the exact number:

1. Do not stop early just because the redness has gone. Stopping too soon is a common reason infections return.
2. Do not extend the course on your own. Prolonged use raises the risk of side effects, resistance, and secondary infection.

If there is no improvement after two days, or symptoms get worse at any point, go back to your doctor rather than continuing.

What if you miss a dose?

Use it as soon as you remember, then carry on as normal. If your next dose is almost due, skip the missed one; do not double up. Setting phone alarms helps, particularly with frequent daytime dosing.

Chloramphenicol eye drops vs eye ointment vs Aplicap

India has a third format that most international guides never mention: the Aplicap, a soft gelatin capsule containing a single application of chloramphenicol eye ointment. Many patients know it as an “eye capsule” or “eye tube capsule.”

Each Aplicap holds enough ointment for one application to both eyes. To use it, wipe the tip clean, snip the end with a clean instrument, and squeeze the contents into the lower lid. It is discarded immediately afterwards.

How to use chloramphenicol eye drops correctly

Getting the technique right matters more than most people expect; a drop that lands on the cheek does nothing.

1. Wash your hands thoroughly before and after.
2. Remove contact lenses if you wear them.
3. Tilt your head back and look up at the ceiling.
4. Gently pull the lower eyelid down to form a small pocket.
5. Hold the bottle above the eye without letting the tip touch your eye, eyelashes, fingers or any surface.
6. Squeeze out one drop into the pocket, then close the eye gently. Do not blink hard or squeeze the lid.
7. Press the inner corner of the closed eye beside the nose — for about one to two minutes. This keeps the medicine on the eye and reduces how much drains into the bloodstream.
8. Wipe away excess with a clean tissue and replace the cap immediately.

If you have been prescribed more than one type of eye drop, leave at least five minutes between them so the second does not wash the first away. Our step-by-step guide to instilling eye drops covers this in more detail, including tips if you struggle to do it yourself.

How to use the eye ointment or Aplicap

Pull the lower lid down, place a short strip of ointment about one centimetre inside the lid, then close the eye and blink a few times to spread it. Vision will be blurred briefly, so do not drive or ride until it clears. For young children, placing the ointment at the inner corner of the eye is often easier than aiming for the lid pocket.

Side effects of chloramphenicol eye drops

Most people tolerate chloramphenicol well, and side effects are usually mild and brief.

Common and usually short-lived

• Stinging or burning immediately after the drop goes in
• Brief blurred vision, especially with the ointment
• Mild watering or itching
• A gritty feeling for a few moments

Do not rub the eye; it makes irritation worse and spreads infection. A clean, cool, damp cloth held over the closed eye helps. Wait until your vision is clear before driving or using machinery.

Rare but serious

Stop the medicine and seek medical help promptly if you notice:

• Swelling of the lips, tongue, face or throat, difficulty breathing, or a spreading rash; these suggest a serious allergic reaction and need emergency care
• Increasing eye pain, marked light sensitivity, or worsening vision
• Persistent swelling, heavy watering or severe irritation

Chloramphenicol has been associated with bone marrow suppression, including aplastic anaemia, a rare condition in which the bone marrow stops making enough blood cells. This risk is chiefly linked to chloramphenicol given by mouth or injection, and it is very uncommon with eye preparations. However, cases following topical use have been reported, which is precisely why the drug is prescription-only and given as a short course.

Contact your doctor if, during or shortly after treatment, you bruise unusually easily, develop a sore throat or fever, or feel unusually tired or weak.

Who needs to take extra care with chloramphenicol

Tell your doctor before starting if you:

• Have ever reacted badly to chloramphenicol or any other medicine
• Have or have a family history of any blood or bone marrow disorder, including anaemia or a bleeding disorder
• Have glaucoma, dry eye, or repeated eye infections
• Have had eye surgery, laser treatment or an eye injury recently
• Have something stuck in your eye, a cloudy-looking eye, an unusual pupil, or severe eye pain
• Are already using other eye drops or ointments
• Are taking medicines that affect the immune system

Children and babies

Chloramphenicol eye preparations are used in children, but in infants they should only be used when a doctor has specifically prescribed them. Newborns clear the medicine less efficiently than older children, and the well-known safety concerns in newborns relate mainly to chloramphenicol given by mouth or injection rather than to eye drops. Never use a leftover bottle on a baby.

Sticky, discharging eyes in a newborn always need same-day medical assessment rather than home treatment.

Pregnancy and breastfeeding

Safety in pregnancy and breastfeeding has not been established. Chloramphenicol crosses the placenta and passes into breast milk, and some product labels advise pausing breastfeeding during treatment. If you are pregnant, planning a pregnancy or breastfeeding, tell your doctor before starting so an alternative can be considered.

Contact lens wearers

Do not wear contact lenses at all while using chloramphenicol. Many formulations contain a preservative that soft lenses absorb, which can cause significant irritation. Wait about 24 hours after your final dose before putting soft lenses back in. Glasses are fine throughout.

How to store chloramphenicol eye drops

Chloramphenicol eye drops are usually supplied refrigerated and should be kept in the fridge, typically at 2°C to 8°C, protected from light. Do not let them freeze. Taking the bottle out a little while before use makes the drops less cold and less startling.

The eye ointment and Aplicaps are generally stored in a cool, dry place rather than the fridge.

Other points that matter, especially in India’s climate:

• Discard the bottle about 28 days after opening, even if liquid remains. Check your pack, as this varies slightly by brand.
• Keep the cap tightly closed and never touch the dropper tip.
• Never share eye medicine, even within a family.
• Do not save a part-used bottle for a future infection. Return unused medicine to a pharmacy for safe disposal.

When to see an eye doctor

Book an eye examination promptly if you have:

• No improvement after two days of treatment, or symptoms getting worse
• Pain in the eye rather than simple irritation
• Reduced or blurred vision that does not clear within minutes of a dose
• Marked sensitivity to light
• A white or cloudy spot on the coloured part of the eye
• Symptoms in a contact lens wearer, after an eye injury, or after recent eye surgery
• A newborn or young infant with a red, sticky or swollen eye
• Repeated eye infections that keep returning

Persistent or heavy discharge deserves proper assessment too. Our guide to eye discharge and what different types mean explains what to look for.

An ophthalmologist can examine the front of your eye under a slit lamp, confirm whether the problem is bacterial, and identify infections that antibiotic drops will not touch.

Conclusion

Chloramphenicol eye drops are an inexpensive, broadly effective treatment for bacterial infections of the eye surface when that is genuinely what you have. Used properly, that means a short course, correct technique, and a follow-up if things are not improving within two days.

Used casually, it is a different picture: no benefit against viral or allergic eye problems, no reliable cover against the organisms that cause contact-lens-related corneal infections, and a delay before the real problem is identified. That is the reason it stays a prescription medicine in India.

If your eye is red, painful, discharging, or not settling, have it examined. A short consultation is a far better starting point than a guess.