Preserve our Eyes, not our Drops!      





What's a Preservative

What are the Consequences

Who's at Risk

Are Labs Aware of This

Are Docs Aware of This

What Preservative Which Drop

Are There Alternatives

What Can You Do

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Who's at-risk?

Everyone is to some extend. The main criteria to evaluate the risk is the frailty of the corneal epithelial cells, the quality/quantity of the tearfilm, the duration of the treatment, the type of preservative used, the dosage of the specific preservative, the residence time of the preservative in contact with the eye.

But as always, there are predisposing factors that aggravate the risk, among which are:

Chronic eye diseases: Because these require long-term treatments and usually several eye drops that contain preservative over several months or years. Among which are:

Dry eyes: Because dry eye are more fragile and prone to allergies, because they don't have enough tears to drain the preservative and protect the eye from preservatives, the consequences of preservatives are exacerbated in a dry eye state. Any type of dry eye state, regardless of the cause, will increase the residence time of preservatives and thus increase risks.

Glaucoma: Glaucoma eyedrops have usually been preserved and require long-term if not lifetime treatments therefore increasing the risk.

Allergic conjunctivitis: Some people are allergic all-year long or during long periods of the year and therefore require the use of eyedrops that in some cases are not available without preservatives. Furthermore, people with an atopic/allergic predisposition are more prone to develop some kind of sensitivity to preservatives.

OSD: Severe OSD such as some Dystrophies (where there is epithelial adhesion issues), Neurotrophic corneas (even mild forms such after LASIK for instance), Recurrent Corneal Erosions, Persistent Epithelial Defect, and basically any type of fragile cornea are more prone to develop ulcers during the use of preserved drops since preservatives increase epithelial cell apoptosis (death).

Contact Lens Use: Contact lens materials tend to absorb preservatives. That's why in preserved drops inserts it is usually advised to remove the lenses and wait 15 minutes at least after removing the lenses to put them on again. The preservative substance is then released onto the eye over very long periods.

But another phenomenon is in cause: Contact lenses are sometimes impregnated with preservative substances used in contact lens solutions do reduce contamination risks. These are necessary in the case of contact lenses but it may be useful to meticulously rinse contact lenses with a non-preserved solution before putting the lenses in eye to reduce the amount of preservative released in eye surface.  A very interesting study was published in the French magazine "60 millions de consommateurs, institut national de la consommation de Janvier 2007,  n°412 dénommée Toxiques et pas toujours efficaces par le docteurs/Produits pour lentilles de contact: Toxiques pour les yeux? en pharmacie Erwan Le Fur & Christian De Thuin". The study analysed the 10 most used contact lens solutions (particularly so-called all in one solution) and the main conclusions relevant to the issues addressed in this website are:

·         Their antibacterial activity is not always sufficient!

·         The presence of preservatives (especially since the package inserts don't warn users to rinse the lenses with non-preserved unit-dose saline solutions) put users at-risk of developing dry eyes and other intolerances. Furthermore, they have toxic effects [this should come as no surprise for our readers!]. Therefore, it was advised to rinse the lenses before wearing them!

·         The contamination risk is increased by 80% in contact lenses users.

·         All the products are toxic in vitro!

·         The inserts should contain the recommendation to rinse the lenses with a non-preserved unit-dose before wearing them.

·         Avoid cigarette smoke! [because cigarette smoke impregnates lenses as well and is toxic!].

If you wear contact lenses, we advise to get a copy of this study.  


This is what we call the 'Preservative Paradox!

Preserve our Eyes, not our Drops!

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