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The Centers for Disease Control and Prevention (CDC) told the public to “immediately discontinue” using EzriCare Artificial Tears on Wednesday. The over-the-counter eye drops could be linked to infections causing vision loss, hospitalization, and at least one death.

The infections were caused by a strain of an “extensively drug-resistant” bacteria called Pseudomonas aeruginosa. The CDC estimates that in 2017, about 2,700 deaths in the US were related to antibiotic resistant Pseudomonas aeruginosa and there 32,600 related cases in hospitalized patients.

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Infections were identified in at least 55 patients in 12 states between May 2022 and January 2023. The Food and Drug Administration (FDA) is investigating the outbreak alongside the CDC and said that most patients had used the artificial tears. 

A majority of the patients identified used EzriCare’s preservative-free, over-the-counter eye drops, but 10 other contaminated brands had been identified. On Thursday, manufacturer Global Pharma Healthcare recalled the eye drops due to the possible contamination. 

The EzriCare distributor based in Lakewood, New Jersey said that it was “not aware of any testing that definitively links the Pseudomonas aeruginosa outbreak to EzriCare Artificial Tears” but “immediately took action to stop any further distribution or sale” of the product.

The CDC warns EzriCare eyedrops may contain dangerous drug-resistant bacteria
EzriCare Product Photos. CREDIT: FDA.

The eyedrops are sold at multiple retailers across the US and are advertised as a treatment for dry-eye that “refreshes, lubricates and moisturizes.” According to the Mayo Clinic, eye drops that do not have preservatives have fewer additives, and are typically recommended for people who use them over four times per day. 

[Related: Antibiotics save lives—but misusing them could lead to millions of deaths.]

The bacteria was found by CDC investigators in the bottles of the EzriCare eyedrops. They are testing to determine if it matches the exact strain found in infected patients and it is not clear if the contamination occurred during the eye drop manufacturing process or when the bottles were opened. 

Pseudomonas aeruginosa is an innately drug-resistant bacterium that is found in freshwater environments. It can cause infections in the skin (wounds and burns included) and lungs. It usually affects immunocompromised individuals and outbreaks have occurred in health care settings among indwelling devices, such as breathing tubes and catheters. It can also lurk in hospital sinks, ice makers, medical device washers, soap bars, and respiratory therapy equipment.

This is the first time that this particular strain of Pseudomonas aeruginosa has been seen in the US. The CDC said that it is showing some “susceptibility” to an antibiotic called cefiderocol.

Symptoms of an eye infection could include eye pain or discomfort, yellow, green or clear discharge from the eye, blurry vision, and increased sensitivity to light.