Watch for Benzalkonium Chloride

[neil0502]

Don't know whether this has been covered here or not. If so, my apologies.

I've been doing a bit of research into the sources and causes of some of my 'superficial' or 'surface' eye pain.

I was treated for roughly six years with cycloplegic drops--the kind the eye doctor uses to dilate your eyes. I used them pretty much daily until a reknowned doc told me that the preservative in the drops, Benzalkonium Chloride ("BAC") eats corneas for breakfast.

The more I look, the more I find to substantiate that position. Here are a couple of links that give you a picture of what happens:

1) BAC decreases Tear Breakup Time (T-BUT -- if yours is low, your tears evaporate very quickly ... and you have problems)

http://www.ncbi.nlm.nih.gov/entrez/q...684&query_hl=3

2) BAC significantly delays corneal epithelial wound healing

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Citation

3) BAC destroys corneal endothelial cells

http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

http://www.ingentaconnect.com/conten...00002/art00013

See what I mean??

All things being equal, I'd stay away from any BAC-containing artificial tears drops, or any other drops--prescription or otherwise--that have BAC. Talk with your doctor about alternatives.

There's a (limited) list of OTC drops and which preservative they contain--as well as a brief discussion of the risks of BAC--on this site:

http://www.agingeye.net/dryeyes/drye...gtreatment.php

You don't want to go through what I'm going through ... and I don't want you to.

Be safe. Read labels. Take good care....

Neil

[Cindy]

Excellent post, Neil. Thank you.

[Pat W]

Bless you neil0502 !

Bless you for this posting. You have helped my research so much with this. I have just started researching dry eye. I have had this at least three years and did not even know such a condition existed until I started seeing the Restasis commercials. The sad part is that I was seeing several eye doctors at that time, and none mentioned they were aware of such a condition. They did not even aknowledge the symptoms I kept telling them about.

This condition may be because I am diabetic, but it did not start until I had to make repeated visits to eye surgeons for a detached retina in one eye. Every time I went, they would keep pouring those drops in Both eyes (checking the other eye repeatedly for diabetic damage). The kept telling me the "good" eye was fine, but I started having the dry eye symptoms. They have gotten worse and worse. I am so bad I am unable to drive. I have been unemployed (can't see for long enough for an employer's needs) for almost two years and I'm almost in the poor house!

I don't believe in coincidences. I have been diabetic for years and years with no eye problems. It's hard for me to believe that the drops didn't have something to do with the dry eye, since I started noticing the symptoms almost immediately after the repeated visits. I have just been investigating for the last couple of weeks, but you are the first person that has mentioned what might be a problem with the drops. I suppose it won't really help me to know now, but I just want to know. Then again, you may have just saved what was left of my eyesight. I have stayed away from eye doctors for the last two years, because I was afraid they would use the drops again and make the eye worse. I was just about ready to try the doctors again and see if I could get a different answer about what the problem was. I think I will wait until I've read all those wonderful links you included. Could be I will refuse any test that includes those drops.

Thank you, thank you, thank you!!!

[Lucy]

Could be I will refuse any test that includes those drops.

Pat, you can refuse any form of medical treatment. No one can force you to take a certain kind of drops. The very worst thing would be to consider you an uncooperative patient and refuse to treat you.

You could, however, talk your problem over with the doctor you see and tell him/her of your past experience. I think most docs will want to work with you (according to your wishes) unless it's totally against their better opinion.
You might ask your family doc who they would recommend as an ophthalmologist or optometrist.

[Jeff]

The very worst thing would be to consider you an uncooperative patient and refuse to treat you.

They put a note on my file in large RED capital letters indicating that I was vocal about my care.

It kind of made me feel like Elaine in that Seinfeld episode, but I can live with that!

Jeff

[neil0502]

For those of you keeping score at home . . . .

I found another excellent article about the link between Benzalkonium Chloride (BAK) and dry eye symptoms/signs. It's four pages--too long to post here--but worth the 10 minutes it might take to browse through it, especially if you've been using any sort of drops that use BAK as a preservative.

As for me ... it's time to heat up my corn bag and get comfy with the living room carpet for a spell

http://www.aios.org/proceed2003/External/Ext11.pdf

[jbrownac]

Thanks Neil for the thoughtful research. I've been definitely trying to not use anything with BAC in it.

I have found a great pharmacy in San Jose which can convert most Rx eye drops to preservative free. The medicine loses some of its potency but its worth it not to have the side effects that you mentioned; especially if you need to take the drops for a significant period of time and your eyes are already sensitive. The place is called Leiter Pharmacy. They are very friendly and are will to answer all your question. They will verify your prescription with your doctor and then mail it out to you.

I currently use Cromolyn (anit-allergy mast cell stabilizer) and Alrex (steroid).