February 2, 2023 - Special Alert

Contents

1. 1. 1. CDC HAN Health Advisory
      2. Key facts
      3. What to do
      4. Video message from Dr. Brown
      5. 1-pager: Eye drops and preservatives
      6. More resources on new DEF website eyedropsafety.org 

CDC Health Advisory

On February 1, CDC released an official Health Advisory via its Health Alert Network (HAN) about a multi-state outbreak of infections from an "extensively drug-resistant strain" of pseudomonas.

This outbreak has been linked to the use of artificial tears:

Patients reported more than 10 brands of artificial tears, and some patients used multiple brands. The majority of patients who used artificial tears reported using EzriCare Artificial Tears, a preservative-free product dispensed in multidose bottles. This was the only common artificial tears product identified across the four healthcare facility clusters.

In the advisory, CDC has recommendations for health care providers, clinical laboratories and the public, and provides more information resources. 

Key facts

• • 55 case-patients (35 are linked to four healthcare facility clusters)
  • 12 states (CA, CO, CT, FL, NJ, NM, NY, NV, TX, UT, WA, WI)
  • Dates: May 2022 to January 2023
  • Do we know the lots? "Thus far, CDC testing identified the outbreak strain in open EzriCare bottles with different lot numbers from two states"
  • Patient presentations: "Patients had a variety of presentations including keratitis, endophthalmitis, respiratory infection, urinary tract infection, and sepsis."
  • Outcomes: Patient outcomes include permanent vision loss resulting from cornea infection, hospitalization, and one death due to systemic infection."

What to do

Read and follow CDC recommendations in the advisory

This includes discontinuing use of EzriCare Artificial Tears and, if you have any signs or symptoms of an eye infection (discharge, eye pain or discomfort, redness of eye or eyelid, feeling of something in the eye, increased sensitivity to light, or blurry vision) seek timely medical care. CDC is not currently recommending testing for people who have no signs of symptoms of infection.

Here are some additions suggestions from Dry Eye Foundation:

1. 1. If you used EzriCare, let your doctor know and retain the bottles in a safe, cool place.
   2. Spread the word. We are concerned that few people will actually be familiar with the brand name. It's in a nondescript dark blue labeled bottle prominently labeled "Artificial Tears".
   3. Consider temporarily avoiding private label and "Similar to..." generic-style over-the-counter drops. This is a developing situation. The manufacturing facility where EzriCare Artificial Tears were made produces many over-the-counter lubricant eye drops and ointments and other ophthalmic products. The EzriCare corporate statement suggests that EzriCare Artificial Tears is being sold under additional labels. Until we know for sure that only EzriCare is affected, this seems a reasonable precaution.
   4. Educate yourself about safe packaging of preservative-free eye drops. (See resources below.) Again, this is an evolving situation, and there is not enough public information to know the actual cause of the outbreak. We do know, however, that the CDC has repeatedly highlighted the fact that this product was preservative-free but packaged in a multi-dose bottle, and we also know that preservative-free eye drops must be packaged either in single-use vials or in special multi-dose bottles that have a preservative-free dropper designed and tested specifically for preventing bacterial contamination of the bottle contents when in use.

Video message from Dr. Brown

1-Pager: Visual Guide to Safe Packaging

For more information, see also:

NEW WEBSITE: eyedropsafety.org

Are your eye drops safe?

Raising awareness of non-prescription eye drop safety concerns

Improperly packaged preservative-free eye drops raise serious sterility concerns. We are seeing more and more eye drops like this on the market now. And this is not the only feature of some non-prescription eye drops that we are concerned about. There are long-term trends that we consumers need to be aware of to keep ourselves safe. 

Visit eyedropsafety.org to read about issues, browse current product alerts, and submit questions.

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