The safety of ophthalmic chloramphenicol has been under review in the UK since 1995, when a letter in the British Medical Journal suggested that its use should be discontinued. The writers consult a wide range of American, European and British research from 1950 to the present to reassure readers that ophthalmic chloramphenicol is a demonstrably effective, safe, cost-effective treatment for most superficial eye infections. They advise colleagues to consider any changes in the provision of antibiotic treatment for ophthalmic conditions carefully, as significant changes in practice may incur cost penalties on departmental or practice drug budgets, and may increase the likelihood of treatment failure which could result in patients having to pay second prescription charges. The requirement for nursing practice to be fully accountable, particularly when nurses are supplying drugs using Trust protocols, is emphasized. The article makes explicit the need for nursing practice to be well considered and based on current, credible research, and offers guidelines for nursing practice when ophthalmic chloramphenicol is supplied under protocol.