Topical and systemic administration of drugs to the eye is highly inefficient and there is a need for controlled, sustained release, particularly for conditions that affect the posterior segment. Various nonimplantable and implantable drug delivery devices have been developed. Colloidal carriers may allow targeted drug delivery and afford protection to substances that are sensitive to degradation, particularly RNA/DNA-based treatments. Gene therapy and cell transplantation are also starting to emerge as alternatives to conventional pharmacological treatment. There is the potential to use existing ocular devices to deliver drugs. In order to exploit this opportunity, modifications to drugs and devices, along with clarification of the appropriate drug dose, must be undertaken. This review will describe some of the treatment options for ocular disease and barriers to drug delivery, discuss the design of existing drug delivery systems and highlight some of the research into combining drug delivery with existing ocular medical devices.