This past week, the U.S. Food and Drug Administration warned consumers not to purchase and to immediately stop using 26 over-the-counter eye drop products, including products from CVS Health and Rite Aid, due to the potential risk of eye infections that could result in partial vision loss or blindness, setting off a flurry of press coverage in the medical community and the news media. The eye drops are marketed by CVS Health, Rite Aid, Cardinal Health, along with Target's Up & Up brand and Velocity Pharma, according to the FDA statement. In response to the recent warning, ODs around the country are stepping up to play an active role in educating concerned patients about eye drop and eye health safety. The agency also asked the manufacturer to recall all lots of the product after its investigators found insanitary conditions in the manufacturing facility.

Unfortunately, this is not the first time that eye drops have been in the news headlines.

• In August, the FDA warned consumers not to purchase and to immediately stop using Dr. Berne’s MSM Drops 5% solution and LightEyez MSM Eye Drops – Eye Repair due to bacterial contamination, fungal contamination, or both.

• In June, the Dry Eye Foundation identified more than 200 eye drops (62 brands) sold online that have potential safety issues. Of these, the majority were packaged exclusively for sale in a country other than the U.S.

• In April, the American Optometric Association (AOA) issued a warning to consumers to stop using EzriCare and Delsam Pharma’s Artificial Tears products by Global Pharma Healthcare. These eye drops were recalled after they were linked to potential bacterial contamination.

VMAIL Weekend reached out to several prominent optometrists, as well as the American Optometric Association (AOA), to find out how patients are reacting to the recent warning from the FDA and how ECPs are dealing with patients’ concerns when it comes to over-the-counter eye drops. Here’s what they had to say.

AOA president Ronald L. Benner, OD told VMAIL Weekend, “It’s imperative that doctors of optometry alert their patients about the recalled eye drops and risk of infection and encourage them to come in for evaluation if they have been exposed to any of these products, regardless if they are experiencing obvious symptoms. We know eye drops are generally safe when manufactured and used properly, and doctors of optometry have long recommended brand-name products from reputable companies.

“While the FDA has not disclosed any adverse events related to eye infections, doctors should report any problems to FDA’s MedWatch Reporting Program. For those with questions we recommend consulting with an AOA doctor at,” Dr. Benner said.

The AOA issued an alert to consumers to stop using the 26 eye drops that were recalled by the U.S. Food and Drug Administration (FDA) as they may cause eye infection and, in some cases, possible vision loss.

The AOA’s alert said, it’s important to note that eye drops are safe when manufactured and used properly. The AOA recommends all patients consult with their local AOA optometrist before purchasing eye drops to ensure an appropriate treatment plan is in place. When talking with a doctor of optometry, it’s also important to share any prescribed and over-the-counter medications currently in use to avoid health complications.

Anyone who owns the recalled eye drops should follow the FDA’s guidelines for throwing the products away, which may involve taking them to a drug take-back site. For the complete list of products recalled, visit the FDA website.

The Dry Eye Foundation recently announced the launch of an easy-to-search eye drop database called "Are My Eye Drops Safe?" Health care professionals and consumers can use this tool to find detailed information on over-the-counter eye drops sold in the U.S., including illegally marketed products, recalled products and products subject to FDA safety communications or warnings.

Susan A. Primo, OD

Susan A. Primo, OD, director of Optometry and Vision Rehabilitation for Emory Eye Center in Atlanta, is encouraging patients to seek medical advice before purchasing over-the-counter eye drops. “Most of what we are seeing has to do with unsterile manufacturing plants for mostly generic products. I typically recommend choosing from a list of five to six brands that I give, which may not always be the cheapest. Other eyecare professionals may have their own ‘favorites.’

“There are also some great new therapies becoming available for dry eye so be careful to go through which one might be best by discussing this with your eye doctor. This might be a good time to step away from the generic products in favor of a new branded formulation even if they can be a bit more expensive,” she said.

“There has been a lot of confusion, even for us as eye doctors, as some of the drops listed appear to be from trusted vendors like CVS and Target. It does seem to be the generic brand name drops at risk now, but we are not 100 percent clear. Fortunately, eye drop recalls have been uncommon in the past, but this uptick is concerning. However, it doesn't appear to extend to Rx drops, only the natural or artificial tears,” she concluded. Dr. Primo is also a member of the board of directors for Prevent Blindness.

Jennifer Chinn, OD, of Dr. Chinn's Vision Care in San Diego, has posted videos on Instagram taking
people through the ins and outs of the latest eye drop warning from the FDA.

Dr. William Hogue

Dr. William Hogue of Vitreous Retina Macula Consultants of New York, specializes in retinal diseases and other eye conditions. He said, “It is always best to seek the advice of an eyecare professional before purchasing drops over the counter. We can recommend trusted brands such as Refresh, Systane or Blink artificial tears, and we can also determine the underlying cause of eye irritation and recommend certain types of drops over others.

“There is confusion among patients as to what is safe. That is one of the more damaging sides to this story. Poor standards by certain companies are fueling distrust against the broader eyedrop market. However, my experience is that if patients are assured there are trusted brands that are not affected it doesn’t waver their confidence too much.

Dr. Hogue cautioned, “It is extremely important patients continue using the drops prescribed by their doctors. Patients’ adherence to their prescribed regimen is essential, especially for conditions like glaucoma, where consistent use of medication is crucial for preserving vision.”

Nathan Bonilla-Warford, OD

Nathan Bonilla-Warford, OD, of Bright Eyes Family Vision Care in Tampa, Florida, offered the following advice for patients. “In general we encourage patients to use specific brand-name products. Right now, we are providing a link to the FDA warning with the list of recalled drops, telling patients to stop using them and throw them away, and if they have any symptoms to schedule an office visit.

“I do think that generally the wide variety of eye drops is intimidating to patients. Most pharmacies have a wall of shelves of products whose labeling can be confusing. The more clear information we can provide to patients the better. “Generally sticking with familiar long-established brands is safest. Because patients will often choose drops not appropriate for their condition (for example, a patient with dry eye choosing anti-redness drops such as Visine), clinical guidance from their eyecare professional is best.

Jennifer Stewart, OD

Jennifer Stewart, OD, of OD Perspectives in New Canaan, Connecticut feels when it comes to eye drops, this is a very confusing time for patients. “I believe in general there is a lot of confusion about generic versus non generic medications. Patients and consumers assume that the generic is the exact same in every way as the name brand medication, which is not always the case. It is our duty to make sure we are recommending products to our patients—because if we don't, they will likely be making choices based on price.

“I make specific recommendations for patients for every type of product they need, including eyedrops. I usually send them home with a sample and/or a coupon, or a tear off sheet so they can buy the exact product.

“This is an incredible opportunity for optometry to continue to show our role as a primary care provider for our patients. By making specific recommendations for them, and by continuing to be a resource for any questions or concerns they have, we can continue to provide the level of care that is needed.

“If your patients are asking you about this news item, take this opportunity to educate them, answer questions and once again, provide specific recommendations for products as part of an individualized treatment regimen,” Dr. Stewart advised.