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7 Mistakes You May Be Making With Eye Drops

Beware of these common errors that can lead to dangerous infections


spinner image closeup of eyedrop medicine bottle
BananaStock / Getty Images

As we age, our risk of developing eye conditions such as glaucoma, cataracts and dry eyes increases. As a result, our reliance on eye drops also spikes.

Several eye drop brands, including EzriCarePharmedica and Apotex, have been recalled in recent months due to contamination concerns that pose the risk of blindness. Most recently, the Food and Drug Administration (FDA) issued a consumer safety warning about amniotic fluid eye drops on the market that were never approved for sale.

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The most concerning of the recalls are those linked to EzriCare eye drops, which have been contaminated with pseudomonas, a virulent bacteria that is resistant to many types of antibiotics, says Daniel Laroche, M.D., an ophthalmologist, director of glaucoma services and president of Advanced Eyecare of New York.

“You have to have a combination of multiple classes of antibiotics to try and treat this,” he says. “It is very aggressive, unlike basic bacterial conjunctivitis that you can get away with coming in [for a doctor visit] a day or two late and it does respond to antibiotics.”

In contrast, pseudomonas can cause a severe infection that can scar the cornea within hours, spread to the inside of the eye in as little as 24 hours, and then penetrate the blood vessels to cause a systemic bodily infection that can result in death. Four people have died because of infections from EzriCare drops.

Even if you aren’t in danger from one of the recalled eye drops, using drops the wrong ways can be harmful to your eyes and increase your risk of infections. Nearly 1 million doctor visits are made each year in the United States for eye infections, including 58,000 emergency room visits, the Centers for Disease Control and Prevention estimates.

To use eye drops safely and effectively, Laroche highlights these mistakes to be avoided.

1. Using eye drops manufactured outside of the United States

Eye drops made outside the United States may not meet the same safety standards as products made domestically, Laroche says.

An FDA inspection of EzriCare’s manufacturing plant in India found a number of sanitary and quality assurance violations, including a “black, brown colored greasy deposit” on a bowl used to transfer bottles and “deficient” processing areas for cleaning and disinfecting the room.

Before using a product, check with the FDA to find out if it is recalled or has a safety alert. Then, inspect the bottle’s packaging to make sure it has not been opened or tampered with and does not appear to be contaminated.

2. Not washing your hands before and after using eye drops

Bacteria can be found on our hands and eyelashes, and can spread from there to our eyes. To reduce the bacterial count, wash your hands often with soap and water and use a warm washcloth to clean your eyelashes.

3. Allowing the dropper to touch your eye

Touching your eyeball with the dropper may contaminate your eye or even the bottle and further the spread of bacteria.

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4. Leaving the eye drop bottle open after use, or storing it in places with too much heat, light or moisture

After use, close the eye drops tightly and store them in a clean, cool place. Do not store eye drops in direct sunlight or near a heat source, as this can degrade the active ingredients and make the drops less effective.

5. Sharing your eye drops with others

If a bottle gets contaminated and then shared with other people, an infection can spread. Staff and residents of nursing homes and hospitals should be particularly conscious of the dangers of sharing eye drops because pseudomonas is more common in those settings.

6. Keeping the drops more than 30 days after opening them

Laroche recommends throwing away all eye drops 30 days after opening because they may harbor bacteria, even if they are stored properly. In particular, preservative-free eye drops, such as those sold by EzriCare, are more likely to spoil. If you choose to use preservative-free eye drops, consider using one-time-use vials, which can be immediately discarded.  

7. Not getting annual eye exams

As we grow older, our eyes undergo changes, which is why it is important for those over age 50 to have an annual eye exam. During the exam, your doctor will assess your vision, look for indications of disease and confirm whether your glasses or contact lenses are still accurately prescribed.

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