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CDC issues warning about infections linked to artificial tears: what you need to know

Dr. Robertson says artificial tears are harmless, but eyedrop bottles can easily become contaminated by touching the eyedrop tip.
Dr. Robertson says artificial tears are harmless, but eyedrop bottles can easily become contaminated by touching the eyedrop tip.

The warning concerns infections in Texas and 11 other states from a drug-resistant strain of bacteria. Most were from users of the EzriCare brand of artificial tears. The maker has recalled it pending further investigation. Dr. Danielle Robertson, an ophthalmologist with UT Southwestern Medical Center, talks about this with KERA’s Sam Baker, beginning with the bacteria.

About the bacteria

Pseudomonas aeruginosais a nasty bacteria. It is found everywhere in nature. A normal, healthy eye is resistant to infection by pseudomonas.

We see pseudomonas infections in the eye when patients have head injuries or they wear contact lenses. Or maybe you have severe dry eye disease. Or you may be immune compromised.

And in this case, now we're starting to see them in patients that have used certain types of eyedrops. My guess is that those patients have a lot of damage on the front surface of the eye from that dry eye, that ocular surface disease. And that's creating a spot for that bacteria to grab hold of the cornea. 

Is the problem having anything to do with the artificial tears solution?

This is where the CDC needs to do their homework and determine if that solution is actually contaminated at the manufacturing plant, or if these are all cases resulting from those tips or the bottles getting contaminated. It's pretty easy to test that. They just need to culture unopened sterile bottles of the solution to see if they can get bacterial growth. 

How dangerous is the pseudomonas? 

Depending on the strain, pseudomonas can eat through the cornea in about 24 to 48 hours.

If you develop a red eye and you've been using one of the products that the CDC has recalled, you want to not hesitate and you want to get in and get those eyes checked because the sooner we can start treatment, the better the outcome will be.

If you get a scar on your skin, it might look bad. If there's scarring on the cornea. It's blindness. 

So, this is not something you could try to take care of yourself at home? Maybe try to wash it out with water or something?

Absolutely not. You have to see your eye care practitioner and you need to be aggressively treated. And antibiotic resistance is the mechanism that the bacteria uses to defend itself against killing by antibiotics. So we want to get a jump start on that infection as soon as we can and as aggressively as we can. The longer you wait, the worse it's going to be. 

Is there anything you can do to prevent infection by Pseudomonas?

Pseudomonas is not going to infect the healthy cornea. If you start developing any signs of infection, we call it the R.S.V.P. clinical rule: Redness and change in vision or pain. You need to get in to see your eye doctor.

Also, if you have dry eye, the safest way to try to lubricate those eyes are to use preservative-free artificial tears. They are single-use containers. So, you just open the container and pop the top. It will still tear into your eyes to lubricate them. And then you throw it away. And then the next time, when you need an eye drop, you're opening a fresh container. Those single-use containers are going to keep you out of trouble.


CDC: Outbreak of Extensively Drug-resistant Pseudomonas aeruginosa Associated with Artificial Tears

FDA warns consumers not to purchase or use EzriCare Artificial Tears due to potential contamination

CDC warns that a brand of eyedrops may be linked to drug-resistant bacterial infections

Sam Baker is KERA's senior editor and local host for Morning Edition. The native of Beaumont, Texas, also edits and produces radio commentaries and Vital Signs, a series that's part of the station's Breakthroughs initiative. He also was the longtime host of KERA 13’s Emmy Award-winning public affairs program On the Record. He also won an Emmy in 2008 for KERA’s Sharing the Power: A Voter’s Voice Special, and has earned honors from the Associated Press and the Public Radio News Directors Inc.