Preservative in eye drops

Preservatives in eye drops may cause damage to the eyes

11/01/2013

Eye drops offer uncomplicated relief for dry, itchy or irritated eyes. However, in the worst cases, the preservatives in the preparations can additionally damage the eye, reports the German Ophthalmological Society (DOG). In particular, with frequent use eye drops should therefore be used without preservatives.

As an example of possible damage to the eye by the preservatives in the eye drops, the DOG experts call chronic inflammation of the ocular surface „the commonly used in ophthalmology benzalkonium chloride.“ According to the information of the German Ophthalmological Society should therefore „Patients with dry eye, glaucoma or contact lens wearers should prefer preservative-free eye drops.“

Preservatives should prevent the spread of pathogens
The preservatives in the eye drops are designed to prevent germs from entering the eye via the drops. Since 1978, they have been prescribed by law in all eye drops that are used for more than 24 hours, the DOG reports. Because without the preservative additive could be in „Multi-dose containers multiply bacteria or fungi.“ In addition, some preservatives facilitate the penetration of the active ingredients into the eye. But also the preservatives offer no absolute protection against the spread of pathogens, because often used eye drops can be detected in one third of the preserved preparations after 15 days also bacteria, according to the DOG. For this reason alone, the benefits of the preservative additives are controversial. In addition, that „especially the commonly used preservative benzalkonium chloride (BAC) has a negative effect on the tear film and the ocular surface,“ emphasized DOG-Presidium member Dr. Elisabeth Messmer from Munich. That way, the eye drops could „Lead to dry eye or worsen the condition of a dry eye“, Instead of achieving a positive effect, the comments in the DOG press release. Patients with chronic eye problems such as glaucoma, who daily rely on eye drops, are especially at risk.

Eye drops without preservative recommended for chronic diseases
Today, eye drops are available with preservatives such as Polyquad, „which harms the surface significantly less than BAC, or sodium perborate and oxychloro complex, but these substances are not completely risk-free. Although tolerated according to Dr. Elisabeth Messmer „Most patients get these preservatives better“, but to exclude completely an irritation can not be here. The safest choice is therefore eye drops without preservatives, reports the DOG. The preservative-free eye drops would be offered today in special containers, of which „some equipped with silver plated steel valves“ are. The valves prevent germs from entering. Another variant is bottles in which a filter absorbs the preservative before contact with the eye. However, the most common are unpreserved eye drops in so-called disposable ophthalmos. According to the experts, a change to alternative preservatives or preservative-free eye drops is generally possible today. However, the advantages and disadvantages must be weighed in each individual case, so the announcement of the German Ophthalmological Society. For patients with dry eye, glaucoma or contact lens wearers the recommendation for a general preservative waiver applies. „In patients with chronic diseases such as dry eye and glaucoma or a proven preservative allergy, preservative-free eye drops should be prescribed“, explained Dr. Messmer. Only with short-term and rare application preservative-containing eye drops are harmless. (Fp)