Eye drops are uniquely fraught with risks because the eye is a site protected from the immune system.
Clear Threat
This year has seen many terrifying things, but perhaps the most surprising was eye drops.
The small, seemingly innocent bottle has led to numerous horrifying headlines during the current crisis surrounding the sun, with long lists of frightening recalls and shocking manufacturing inspections and reports of people developing almost untreatable bacterial infections, losing their eyes and vision, and even dying.
Apparent Risks
Therefore, the Food and Drug Administration issued guidance titled “What You Need to Know About Eye Drops” in an effort to prevent this year’s danger from leaking into next year. Among the notable points from the regulatory body was this stern statement: no one should use any homeopathic eye product, and every such product should be removed from the market.
This point is unexpected, as none of the prominent infections and recalls this year involved homeopathic products. But it should be welcomed by any supporter of evidence-based medicine.
Homeopathy is Quackery
Homeopathy is quackery that produces placebo treatments that do no better than placebo and, if prepared incorrectly, can be toxic, even deadly. This practice relies on two false principles: “law of similars,” or “like cures like,” which means that a substance causing specific symptoms in a healthy person can treat conditions and diseases involving the same symptoms, and “law of infinitesimals,” which states that diluting a substance makes it more effective. Thus, homeopathic products begin with toxic substances that are highly diluted—often to oblivion—in a ritualistic procedure. Some homeopaths believe that water molecules can retain “memory.”
Apparent Risks
In the United States, these products are marketed as legitimate treatments and sold alongside evidence-based treatments (despite consumer advocates’ efforts to change that). The reason this is currently allowed is due to a regulatory loophole: under the Food, Drug, and Cosmetic Act of 1938, homeopathic products are generally exempt from pre-market safety and efficacy reviews by the FDA as long as the active ingredient in the product is listed in the homeopathic pharmacopoeia, a list of substances approved by homeopaths.
In recent years, the FDA and the Federal Trade Commission have ramped up scrutiny of homeopathic products. Current guidance indicates that the FDA is not backing down from oversight of homeopathic eye products. The regulatory body states that any products intended for the eye “pose an increased risk of harm” because the eyes are a site protected from the body’s immune system. This means that innate immune responses are suppressed in the eye to prevent infections that could harm vision. “Any medication used in the eye must be sterile to minimize the risk of infection,” according to the FDA.
But whether homeopathic eye drops are sterile or not does not seem to matter to the FDA. The regulatory body warns: “Do not use eye products labeled as homeopathic, as these products should not be marketed.” The lack of pre-market safety and efficacy reviews appears sufficient to warrant avoidance.
Additional Warnings
The FDA also warns consumers against using any eye drop product without a prescription that claims to treat glaucoma, surgical recovery, or retinal degeneration, as there is no actual treatment for these conditions. If an over-the-counter product claims that, you can assume it is quackery and avoid it. Consumers should also avoid anything containing methylsulfonylmethane (MSM), which is illegally sold in the United States, and anything containing silver sulfadiazine or argentum, as they can permanently stain the white part of the eye.
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Beth Mole is a senior health correspondent at Ars Technica. Beth holds a PhD in microbiology from the University of North Carolina at Chapel Hill and participated in the science communication program at the University of California, Santa Cruz. She specializes in covering infectious diseases, public health, and microbes.
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