Preservative in eye drops

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Preservatives in eye drops can cause eye damage

Eye drops promise easy relief from dry, itchy or irritated eyes. In the worst case, the preservatives in the preparations can additionally damage the eye, reports the German Ophthalmological Society (DOG). Especially with frequent use, eye drops without preservative should therefore be used.

As an example of possible damage to the eye due to the preservatives in the eye drops, the DOG experts cite chronic inflammation of the eye surface due to "the benzalkonium chloride common in ophthalmology." According to the German Ophthalmological Society, "patients with dry eyes, glaucoma or contact lens wearers should prefer preservative-free eye drops. "

Preservatives are intended to prevent the spread of pathogens. The preservatives in the eye drops are intended to prevent germs from entering the eye through the drops. Since 1978, they have been prescribed by law in all eye drops that are used for longer than 24 hours, reports the DOG. Because without the preservative additive, bacteria or fungi could multiply in “multi-dose containers”. In addition, some preservatives make it easier for the active ingredients to penetrate the eye. However, the preservatives also do not offer absolute protection against the spread of pathogens, because with frequently used eye drops, bacteria can also be detected in a third of the preserved preparations after 15 days, according to the DOG. For this reason alone, the benefits of preservative additives are controversial. In addition, "Above all, the commonly used preservative benzalkonium chloride (BAC) has a negative effect on the tear film and the surface of the eyes," emphasized DOG Presidium member Dr. Elisabeth Messmer from Munich. In this way, the eye drops could “lead to dry eye or worsen the condition of a dry eye” instead of achieving a positive effect, according to the DOG press release. Here, patients with chronic eye disorders such as glaucoma who rely on eye drops daily are particularly at risk.

Eye drops without preservatives recommended for chronic diseases Today, eye drops with preservatives, such as Polyquad, are available “which damages the surface significantly less than BAC, or sodium perborate and oxychloro complex, but these substances are also not completely risk-free. According to Dr. Elisabeth Messmer "most patients use these preservatives better", but irritation cannot be completely ruled out here either. The safest choice is therefore eye drops without a preservative, reports the DOG. The preservative-free eye drops would be offered today in special containers, some of which “are equipped with silver-plated steel valves”. The valves prevent germs from entering. Another variant are bottles in which a filter soaks up the preservative before contact with the eye. The most common are unpreserved eye drops, however, in so-called single-use vials. According to the experts, it is now generally possible to switch to alternative preservatives or preservative-free eye drops. However, the advantages and disadvantages must be weighed in individual cases, according to the announcement of the German Ophthalmological Society. For patients with dry eyes, glaucoma or contact lens wearers, the recommendation to avoid general preservatives applies. "Preservative-free eye drops should be prescribed for patients with chronic diseases such as dry eye and glaucoma or a confirmed preservative allergy," explained Dr. Messmer. Only with short-term and infrequent use are eye drops containing preservatives harmless. (fp)

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Video: Causes of Dry Eyes Explained by Dr. Berg


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