Eyedrop recall 2023: Brands linked to Pseudomonas aeruginosa infection


In the United States, two more people have died after being infected by Pseudomonas aeruginosa, a drug-resistant bacteria that has been linked to eye drops, according to the Centers for Disease Control and Prevention, bringing the death toll to three. The outbreak has also been linked to eight recent reports of vision loss and four reports of enucleation or surgical removal of an eyeball.

The agency first warned of the outbreak in January, which has now infected at least 68 people in 16 states. Soon after, EzriCare Artificial Tears, an over-the-counter preservative-free product that many infected patients reported using, was recalled by the manufacturer.

Several other eye products have since been pulled from the shelves, though not all of them are related to the bacterial infection. With millions of Americans using eye drops every day — the vast majority of them safely — news of the illness and recalls has sparked concern and confusion.

Here’s what you need to know.

Which eye drops have been recalled?

At least four eye drops have recently been recalled. They include the artificial tears from EzriCare and Delsam Pharma, which have been linked to the bacterial infection.

Two other products – Pharmadica USA’s Purely Soothing, 15% MSM Drops and Apotex Corporation’s Brimonidine Tartrate Ophthalmic Solution, 0.15% – were also pulled by their makers, although they are not related to the outbreak.

Patients who have contracted infections from Pseudomonas aeruginosa reported using more than 10 brands of artificial tears, but none as frequently as EzriCare, according to the CDC.

David Chen, an ophthalmologist at National University Hospital in Singapore, said in an email that he doesn’t believe people should worry about other brands that haven’t been recalled. He advises taking “general precautions when using artificial tears” such as avoiding finger contamination and disposing of them within the advised time.

Pharmadica USA recalled Purely Soothing, 15% MSM Drops in March over concerns that the product is not sterile. The drops have not been linked to illness, the company said, though it warned that using contaminated eye products could increase the risk of infections that could lead to blindness. Also in March, Apotex Corporation recalled Brimonidine Tartrate Ophthalmic Solution, 0.15% “out of an abundance of caution” because of cracks in some bottle caps, which could compromise the sterility of the product, the company said.

CDC warns EzriCare eye drops may be associated with bacterial infections, 1 death

Delsam Pharma’s artificial eye ointment, which is not directly associated with disease but was produced by Global Pharma Healthcare, the same manufacturer behind Delsam Pharma’s artificial tears, has also been recalled.

What are the symptoms of eye infection to watch out for?

If you’ve used Ezricare and Delsam Pharma’s artificial tears, watch for symptoms such as yellow, green, or clear discharge from the eye; eye pain or discomfort; redness of the eye or eyelid; a feeling that something is in your eye; increased sensitivity to light; and blurred vision, according to the CDC.

The CDC instructs those who experience such symptoms and have used one of the two eye drops to seek immediate medical attention. People who do not experience symptoms do not need to test for possible infection, it says.

More eye drops are being recalled. Here’s what you need to know.

A serious eye infection can resemble less threatening conditions such as dry eye and other autoimmune or inflammatory diseases of the eyes, experts warn.

“If it’s really bacterial, a direct eye exam will determine it, as we can see certain clinical features that would suggest bacteria and the degree of infection,” Dave Patel, an ophthalmologist at the Mayo Clinic in Phoenix, told The Post.

What is Pseudomonas aeruginosa?

Pseudomonas aeruginosa is an aggressive bacteria that can be found everywhere in the environment, including in water, soil and human waste. It can enter eye drops through contamination with environmental agents during handling, experts say. The bacteria is resistant to most antibiotics and is particularly dangerous in healthcare settings and for people with weakened immune systems.

Elizabeth Connick, a professor of medicine and immunobiology at the University of Arizona, said the bacteria “secretes proteins that can destroy the clear tissue in the front of the eye — the cornea — and cause it to enter the eye. It can impair vision or even blind someone.”

Pseudomonas aeruginosa tends to cause problems in places where “immune responses are blunted,” Robert T. Schooley, distinguished professor of medicine in the division of infectious diseases and global public health at the University of California San Diego, previously told The Post.

But when medical products such as eye drops become contaminated, “the concentration of bacteria — or viruses or fungi — in the product can be extremely high and overwhelm local immune responses, even when people are not overtly immune compromised,” he said.

Infections can present in ways such as keratitis, sepsis, and respiratory and urinary tract infections. In 2017, there were about 2,700 deaths from HIV in the United States Pseudomonas aeruginosa and 32,600 cases in hospitalized patients, according to CDC estimates. The eye drop-related strain of Pseudomonas aeruginosa has not previously appeared in the United States, according to the CDC.

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