Eye drops and safety issues: Here’s what you need to know now
In light of recent news that a brand of over-the-counter eye drops may have caused bacterial infections leading to loss of vision and even deathconsumers may be hesitant to use them at all.
Thomas Stokkermans, OD, PhD, director of optometric services for University Hospitals Cleveland Medical Center in Cleveland, Ohio, said eye drops are generally completely safe to use.
“Reported infections from eye care products are extremely rare,” he told Fox News Digital in an email.
“It is much more likely that misuse of eye care products will cause injury.”
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The Centers for Disease Control and Prevention (CDC) on Jan. 20 called on people to stop using EzriCare Artificial Tears after 50 patients reported eye infections associated with the product.
The bacteria, Pseudomonas aeruginosa – which is resistant to many antibiotics – has been linked to respiratory infections, urinary tract infections, permanent vision loss, hospitalization and even one death.
Dr. Stokkermans saw one of the affected patients in the ophthalmology department of UH Cleveland Medical Center.
The person lost almost all of her vision in the affected eye.
A bacteria in EzriCare Artificial Tears has been linked to respiratory infections, urinary tract infections, permanent vision loss, hospitalization and even one death.
On Feb. 23, the Food and Drug Administration (FDA) urged consumers not to buy or use another product, Delsam Pharma’s Artificial Eye Ointment, due to possible bacterial contamination.
Long before the EzriCare and Delsam Pharma incidents, other eye products had been recalled due to eye infections, Dr. Stockmans.
In previous cases, the infections apparently came from contact lens fluids.
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“In May 2007, the CDC linked AMO Complete MoisturePLUS contact lens solution to reports of Acanthamoeba keratitis, a rare parasite that can cause a serious and potentially blinding eye infection,” he said.
“And in May 2006, the FDA issued a recall of B&L’s ReNu Moisture Loc after several users reported fungal infections of keratitis, which are serious and difficult to treat. B&L ultimately settled 600 lawsuits from people affected by this infection.”
Infections seen as the exception, not the rule
Dr. Stokkermans called the EzriCare-related infections “very unfortunate”.
He said they have eroded consumer confidence in access to safe, healthy medicines and supplements.
“Often there is no way to know in advance that a manufacturer has produced a tainted product until a number of consumers have been affected and it is advertised in the news,” he said.
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“It’s important to remember that it’s extremely rare for eye drops to be recalled because of microbial infections.”
He added that the best protection against infection or eye disease is to treat the eye only with drops prescribed or recommended by a doctor.
Optometrist Juanita Collier, MS, OD, FCOVD, offers vision therapy at her 4D Vision Gym office in Cromwell, Connecticut.
She said eye drops containing preservatives are generally safe to use because the preservatives safely extend the life of the drop and protect against pathogens. However, she recommends being careful with preservative-free brands.
How do you know if you have an infection?
With allergies and other medical conditions that often cause red, itchy, and watery eyes, it can be difficult to determine when the symptoms indicate an infection.
“Bacterial infections are often associated with sticky discharge and redness, along with a feeling as if there is sand in the eye, which is known as foreign body sensation (FBS),” explains Dr. Stockmans out.
Viral infections will most likely only involve tears and FBS, while allergies are more associated with itching, lacrimation and swelling, the doctor said.
Infections can also affect the conjunctiva, the thin, clear membrane that protects the eye. When this becomes inflamed or infected, it can cause a condition called conjunctivitis, more commonly known as pink eye.
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When the infection affects the cornea (the surface of the front of the eye), it can cause a condition called keratitis, in which the cornea becomes inflamed, said Dr. Stockmans.
“The Pseudomonas aeruginosa infections [associated with EzriCare Artificial Tears] caused a type of keratitis where the infection broke the surface of the cornea,” the doctor said. “This is called a corneal ulcer, which is the most dangerous of the types of infection discussed and can lead to blindness.”
“One of the main signs of a serious problem is when the red eye is accompanied by blurred vision or vision loss.”
Since infections, allergies, and general sensitivities can have some of the same symptoms, it’s always best to see an ophthalmologist.
“One of the main signs of a serious problem is when the red eye is associated with blurred vision or vision loss,” said Dr. Stockmans.
In that case, he recommends going to the emergency room.
Many eye drops will sting a little when first put in, which is usually not a cause for concern, said Dr. Necklace.
“If an eye drop burns excessively, discontinue use and call your ophthalmologist immediately,” she said.
Tips for safe use of eye drops
Before using any type of eye drop, Dr. Stokkermans that it is important to ensure that the tamper-resistant seal has not been broken.
Then check the expiration date and verify that you are using the correct product.
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“I’ve personally had patients who thought they were using their regular eye drops and put superglue in their eyes instead,” he said.
Dr. Collier advises her patients never to put the tip of the bottle in their eye – no matter what kind of drops they use – because that is a major entry point for pathogens and can also scratch the eye.
Dr. Stokkermans also recommended this safety advice: “If you use preservative-free drops, you should throw away the packaging after use. The contents of preservative-free products do not kill or slow the growth of microbes and can easily become contaminated with an infectious agent.”
For best results when applying an eye drop, Dr. Stokkermans told you to sit in a chair, tilt your head back and look up.
Pull down the lower eyelid and instill a single drop into the pocket that has formed between the eyeball and the lower eyelid.
If you use different types of eye drops, he recommends waiting 15 minutes between each application.
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Between uses, eye drops should be stored at room temperature or in a refrigerator as directed on the label.
“Droplets exposed to high temperatures can lose the ability to slow microbial growth,” said Dr. Stockmans. “I had a patient who contracted Acanthamoeba keratitis [a rare but serious infection of the eye] after he forgot his eyeglass in the tumble dryer.”
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Those who are unsure about the safety of an eye drop product can check the FDA’s website for any recalls or warnings.
“The most important thing is to check with your optometrist before starting any drops,” said Dr. Necklace.