CDC: Artificial Tears Eye Drops May Be Linked To 50 Infections, One Death

Talk about dropping some eye-opening news. An antibiotic-resistant strain of the bacteria Pseudomonas aeruginosa has been going on a bit of tear, so to speak, causing eye infections in at least 50 people across 11 different states. These infections in some cases have resulted in bad, bad, bad stuff, including permanent vision loss and one death. And the Centers for Disease Control and Prevention (CDC) does have an “eye-deer” of what the source of this bacteria may possibly be: artificial tears eye drops.

Yep, according to a document circulated by the American Academy of Ophthalmology (AAO), the CDC has been investigating this growing number of eye infections with the first being detected on May 17, 2022. Cases have appeared in California, Colorado, Connecticut, Florida, New Jersey, New Mexico, New York, Nevada, Texas, Utah, and Washington. Cultures have revealed a type of bacteria with a really, really long name: Verona Integron‐mediated Metallo‐β‐lactamase (VIM)‐ and Guiana‐Extended Spectrum‐β‐Lactamase (GES)‐ producing carbapenem‐resistant Pseudomonas aeruginosa (VIM‐GES‐CRPA). That’s indeed quite a mouthful. It kind of makes saying “She sells seashells by the seashore”, Zach Galifianakis, or Maggie Gyllenhaal easy by comparison.

What’s been common among the people afflicted with these infections wasn’t a mouthful, though. It was an eyeful instead, an eyeful of artificial tears. Yes, the CDC found that those who had developed eye infections tended to do so not too long after they had used artificial tears, most commonly EzriCare Artificial Tears, a brand of preservative‐free eye drops. Talk about tearing us apart. And guess what the CDC found when they tested EzriCare bottles that had already been opened. No, not Galifianakis. Not Gyllenhaal. Not seashells by the seashore. But VIM-CRPA.

You’ll notice that VIM-CRPA is missing the GES. That’s because the CDC hasn’t found the GES yet in the bottles. They’re still testing for that. The VIM of the VIM-GES-CRPA name stands for one type of enzyme—Verona Integron‐mediated Metallo‐β‐lactamase—present in the bacteria that can break down and thus neutralize particular types of antibiotics. Thus, VIM gives the Pseudomonas aeruginosa some extra vim and vigor to resist antibiotics. Similarly, the GES is another type of antibiotic neutralizing enzyme: Guiana‐Extended Spectrum‐β‐Lactamase. Together VIM and GIS have helped this version of Pseudomonas aeruginosa become resistant to a range of antibiotics such as carbapenem, ceftazidime, and cefepime.

Typically, you can find Pseudomonas aeruginosa in many of your surroundings such as water and soil, which is another reason why it’s not a great idea to smear soil into your eyes. This bacteria can thrive in a lot of different situations ranging from where oxygen is readily available to where oxygen is in short supply. Even though you can find this bacteria around you, there’s never a time when you should say, “I could use some Pseudomonas aeruginosa in my pants right now” or anywhere on your body for that matter. It can infect many different parts of your body, including your respiratory tract, urinary tract, breaks in your skin, your bloodstream, and, yes, your eyes. Therefore, it’s not a surprise that the CDC has recommended people drop the use of EzriCare Artificial Tears for now, at least until all of the epidemiological investigation and laboratory analyses have finished.

So is this a total recall situation? Well, on January 24, 2023, when they first became aware of the CDC’s investigation, EzriCare, LLC, didn’t immediately drop selling their product. They posted on their website that they had “received no consumer complaints or adverse event report related to the investigation to date.” They did not issue a recall at the time because they hadn’t “received communication from any regulatory agency providing any outcomes or details to EzriCare about the ongoing investigation. We have not been asked to conduct a recall.”

Ah, but EzriCare has since decided to “tear” up their original stance. In a February 1 announcement, they emphasized that “we are not aware of any testing that definitively links the Pseudomonas aeruginosa outbreak to EzriCare Artificial Tears. Nonetheless, we immediately took action to stop any further distribution or sale of EzriCare Artificial Tears.” EzriCare mentioned that their Artificial Tears product is manufactured in India by Global Pharma Healthcare PVT Limited and imported by Aru Pharma Inc. into the U.S. They also stated that they “understand that Global Pharma Healthcare PVT Limited will be initiating a recall of the product, but as of the date and time of this Press Release that has not happened.”

It seems like the current concerns focus on the EzriCare Artificial Tears. The CDC hasn’t mentioned eyeing other brands of eye drops as well. So presumably there’s no need to discontinue use of any other brands. Nevertheless, you may want to see what news drops in the coming days. It’s a good idea to keep an eye on the CDC investigation as they are doing things like checking unopened bottles of EzriCare Artificial Tears to see if they can find this bacteria. And keep an eye out for an anticipated recall of EzriCare Artificial Tears. After all, don’t want Pseudomonas aeruginosa in your eye is a good reason to get your money back.