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How paranoid are you about BAK?

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  • How paranoid are you about BAK?

    Sounds like BAK is an undesirable preservative. I'm trying out some Alrex, which contains BAK. I'm supposed to use it twice a day for a month. Should I be concerned? I'm not sure what my alternative is, except to stop treatment.

    I've been using the Alrex for two days and it did seem to be helping, but now I seem to have a minor infection/pink eye thing going on in one eye, which is suspicious. The data sheet suggests that Alrex can make infections worse, so I guess I'll lay off it until my eyes get white again. It's weird because the first night I used it, they were the whitest I may have ever seen them.

  • #2
    You should talk with your doctor about this. If you paid for an office call and he prescribed this med for you and you don't take it, that's a bit of a waste.

    You should call the dr and ask him what to do. If you stop an antibiotic in the middle of treatment, or after two days, you will make the whole treatment plan questionable.

    BAK is not a good thing, but I think taken for a couple of weeks or so will not do damage. It's likely to cause trouble if taken consistently over a long period of time. I don't know what that length of time is since I'm not a dr.

    Mastiff, good luck with your eye situation. Lucy
    Don't trust any refractive surgeon with YOUR eyes.

    The Dry Eye Queen


    • #3
      I have asked him. He's not concerned, but then he has never acted like he even knew what I was talking about when I asked if it was safe to put tons of wetting drops in. Alrex is steroid by the way.


      • #4
        Sorry about my confusion on the drops. I should have known better. Lucy
        Don't trust any refractive surgeon with YOUR eyes.

        The Dry Eye Queen


        • #5
          I am freaked out by any eye drops with steroids

          They make my eyes feel like they are going to blow right out of their sockets (could be more of a preservative issue). (my right eye always feels that way all the time though )

          Have you thought about changing docs since this one doesn't seem to know what you are talking about or maybe not listening to you so well? I have had to do that numerous times, which is sometimes how you end up finding a good one.


          • #6
            BAK caused my MGD - it started off as an irritated eye and a bit bloodshot. So I used more of the lubricant (with BAK) and now I have 'incurable' MGD - my advice is to be concerned stop using the BAK product and don't listen to a regular doctor only to corneal specialist.

            BAK = evil
            The magic gloop IS out there somewhere - right?


            • #7
              BAK appeared to cause my dry eyes and my red eyes initially... That is my opinion. I now have MGD too so I would not recommend anything with BAK unless you are under the strict care of a corneal specialist and using the product for a very very limited period of time...


              • #8
                Are there any studies or anything , or even scientific theories, as to how BAK could cause permanent damage to the M-glands like you guys are suggesting? I found one article talking about damage to the cornea itself when BAK is used over the very long term, as in elederly cataract patients who use drops multiple times daily for years.

                I'm seeing improvement with the Alrex, and I'm picturing myself trying to explain to my eye doc that I have to stop because of stories I heard from people on the internet. No offense.

                My MGD appeared to come on suddenly too, and after reading these forums I was tempted to blame it on some drops that I think I used around that time. But then, I bet dry eye always seems to come on suddenly when it hits some threshold of where you actually notice. For me it was when I woke up with foggy vision in the morning. I think in reality though, it was coming on for years given other little hints, like extra watery eyes in the winter wind.

                I'll look into a corneal specialist, but that's kind of abstract to me at this point. I live in a town of about 200,000 people. There are ophthalmologists, optometrists and lasik doctors. The optometrist seems totally in his comfort zone, like he deals with several dry eye people per day. I'm not saying that makes him an expert, but it also seems like I'm in the place where people are expected to go for dry eye.


                • #9
                  BAK is clearly not desirable and I do not know why Alrex is not readily available in preservative-free form. I use Alrex twice a day and feel a slight burn when I put it in. If you are reacting to it in any way, please tell your doctor immediately.


                  • #10
                    See I don't get this... everytime I use drops with BAK, my MGD not only feels better but it also gets better, eg I get a reduction in inflammation.

                    Now what I am wondering is if lid scrubs caused some irreversable meibomian gland damage, I would be way more concerned with that than BAK. Cause I use a butt load of this preservative lately. Going to talk to my doctor about it in a week but if anyone should be worried it should be me lol.

                    And I think the BAK does give your eyes a disctinct feeling, like they are dry I guess is how I would describe it. But my combo here lately is just rotate lotemax, tears and azasite till my eyes are working on their own, since I can't take oral doxy anymore

                    Also symptoms should be a good indicator of damage being done to your eyes, if you are paying attention to that sorta thing. And boy when I do a lid scrub it takes so many different drops to get my eyes feeling normal again where as when I use drops with bak they feel fine.
                    Which is it? Is it what you know or who you know? Or is it how well you convey what you know to who you know it to?



                    • #11
                      Hi, guys!

                      ... just reminder: You can learn more about the use of BAK and it's consequenses at

                      Also, we have a petition going on (that many of you have already signed, thank you!), and more signatures are always welcome:

                      Greetings from Toril (member of Keratos).


                      • #12
                        Anything, overused could cause problems. BAK is no exception.

                        MY Dr.s know about it. I have asked a couple, and was told they just don't think it is a big deal short term.
                        ( Corneal specialists )
                        They told me try to use preservative free for daily use drops,
                        But the risk of contamination is greater, than the dangers of BAK.
                        Especially for a damaged cornea, or before or after surgery, contaminated drops would be very harmful.

                        I think that a lot of times what we think may have caused our problems may be just a coincidence.
                        For example , If someone developed MGD while using a drop with Bak,
                        You have to wonder if they would have even without the BAK.
                        They were using the drop for some reason, so there must have been something wrong.

                        Maybe , the problem was already there, just in the early phase.


                        • #13
                          Here are my main concerns with BAK:

                          1) BAK in artificial tear products.

                          Yes, there are still several tears out there with BAK including some in the Visine product line. I think it is absolutely, terribly wrong to put an OTC tear of any kind on the shelf with BAK because artificial tears will get used regularly, BAK is not safe for regular use, and people who use artificial tears probably have dry eye meaning they are even more vulnerable to BAK's adverse effects.

                          2) BAK in all other OTC products (vasoconstrictors and allergy drops)

                          Even though the labels may say use temporarily, see a doctor if it persists more than 2-3 days, etc, the fact is people frequently abuse these drops without having any idea what the possible consequences could be. (Come to think of it, I guess I feel this way about vasoconstrictors in general.) If it's known to be used frequently, it shouldn't have BAK unless the user is under the supervision of a doctor who can tell them what product to use and can check up on their condition.

                          3) BAK in Rx products for prolonged or chronic use - the classic example being glaucoma drops, which are usually prescribed to the elderly, who usually have dry eye and so are especially vulnerable, which makes the whole picture even worse.

                          As for antibiotics and steroids, I'm on the fence. I wish the pharmas would hurry up and phase over to some better, safer preservatives and more non preserved ones as well. I hope that through activism & publicity that will happen. Meantime, personally the BAK wouldn't stop me from using an Rx drop that I really needed and I would probably be too lazy to try to figure out whether there was a decent non BAK alternative available. But it's a very individual decision.
                          Rebecca Petris
                          The Dry Eye Foundation