by WILLIAM CORKINS, OD
When the FDA approves eye drops, the drops are required to have a preservative added. Most people think a preservative makes the eye drops last longer, which it does not. If I am instilling an eye drop in my eye and I accidentally touch the tip of the bottle to my eyelashes, bacteria can be transferred to the tip of the bottle.
The bacteria could then find its way into the bottle’s contents. The bacteria could thrive, so when you instill the drop in your eyes, you could transfer the bacteria to your eyes, causing an infection. The infection could lead to scarring of the cornea, which can cause permanent vision loss. If this scenario were to happen, the preservative in the bottle would kill the bacteria, hence why the FDA requires it. This sounds like a good idea, but if the eye drop is used often, the preservative can cause an allergic reaction. The eye will become painful and red, the lids will swell, and your vision will become blurry.
These signs and symptoms will go away once you stop using the drops.
The antibiotic, steroid, nonsteroidal, and allergy drops and ointments we prescribe have preservatives in them. Still, they usually do not present a problem because they are used for a short period. Problems can surface if you must use the drops on a frequent or long-term basis. We experience this a lot when we are treating dry eyes and glaucoma. Both conditions require the use of drops on a frequent schedule chronically. Consequently, we see many allergic reactions to the preservatives that the FDA requires to be in the drops.
So, we find ourselves in a position where we are trying to treat an eye condition and cause the patient to have another problem, an allergic reaction. With these cases, we must change to a preservative-free drop. This will solve the problem, but preservative-free drops for dry eyes cost more, and patients are unhappy about paying more. Preservative-free glaucoma drops also cost more, and often, the insurance companies do not want to pay for them even though we tell them that their drops are causing an allergic reaction. This forces patients to consider surgical options for the treatment of their glaucoma. The surgical options do have risks, and a lot of the time, the patient will still need glaucoma drops after surgery. When this happens, we spend a lot of time arguing with the insurance companies to try and convince them to cover the preservative-free glaucoma drops.
The next time your eye doctor says you will need preservative-free drops for your dry eye condition and or glaucoma, you will have a better understanding of what they are trying to manage.
Bio: Dr. William Corkins is a board-certified optometrist who practices at the Haines City location for Eye Specialists of Mid-Florida. He is currently accepting new patients. Call 800-282-3937 or visit us online at eyesfl.com to schedule your next eye care exam.
This column is sponsored by Eye Specialists of Mid-Florida, and the opinions expressed herein may not reflect those of CFHN or of its advertisers. Post navigation
