Three people have died and four people have had eyeballs removed after using eyedrops linked to a drug-resistant bacterial disease.
This week, the Centers for Disease Control and Prevention (CDC) issued an update in the wake of four eyedrops recalled by their manufacturers, two of which have been directly linked to Pseudomonas aeruginosa: EzriCare Artificial Tears and Delsam Pharma’s Artificial Tears. Eight other cases of vision loss have been reported.
The CDC issued a recommendation to health care providers on February 1, saying, “Immediately discontinue using EzriCare Artificial Tears pending additional guidance from CDC and FDA. Advise patients who used EzriCare Artificial Tears to monitor for signs and symptoms of infection. Perform culture and antimicrobial susceptibility testing when clinically indicated.”
The same day, EzriCare issued a statement that they had “first received notice of the CDC’s ongoing investigation into a multistate cluster of Pseudomonas aeruginosa infections on January 20, 2023. As of today, 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.”
“If it is truly bacterial, a direct eye exam will determine it, since there are certain clinical features we can see that would suggest bacteria and the degree of infection,” Phoenix’s Mayo Clinic ophthalmologist Dave Patel explained to The Washington Post.
As of March 14, 2023, the CDC identified 68 patients suffering from VIM-GES-CRPA, a rare strain of Pseudomonas aeruginosa, between May 2022 and February 2023, in 16 states: California, Colorado, Connecticut, Florida, Illinois, North Carolina, New Jersey, New Mexico, New York, Nevada, Pennsylvania, South Dakota, Texas, Utah, Washington, and Wisconsin.
“Patients should stop using EzriCare or Delsam Pharma’s Artificial Tears pending additional information and guidance from CDC and FDA,” the CDC warned. “Patients who have used EzriCare or Delsam Pharma’s artificial tears and who have signs or symptoms of an eye infection should seek medical care immediately.”
Symptoms for concern include, according to the CDC:
- Yellow, green, or clear discharge from the eye
- Eye pain or discomfort
- Redness of the eye or eyelid
- Feeling of something in your eye (foreign body sensation)
- Increased sensitivity to light
- Blurry vision
Elizabeth Connick, professor of medicine and immunobiology at the University of Arizona, said of Pseudomonas aeruginosa that it “secretes proteins that can destroy the clear tissue at the front of the eye — the cornea — and allows it to invade the eye. It can impair vision or even blind someone.”
Robert T. Schooley, professor of medicine at the University of California at San Diego, said that when 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.”