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Choosing Over-the-Counter Drops
When I go to the pharmacy section for eye care, I am amazed at the array of products. Unless you’re specifically told by your eye doctor what to get, how are you supposed to make a buying decision?  What if it’s the wrong medicine for your condition?
Over-the-counter drops consist of a few main categories.  The first category is contact lens solutions.  Most of these are for soft lenses and are a one-step system which contains a cleaner used while rubbing, a disinfectant, and a rinsing solution.  Over the past 15 years, these solutions have been improved by making the cleaner gentler and therefore able to be directly instilled in the eye.  Examples of this are Opti-Free, Pure Moist, Biotrue, etc.  Interestingly two of these solutions, Clear Care and Aosept are actually hydrogen peroxide-based solutions and should not be used directly in the eye.  
Each of our doctors has responded to a call on an urgent basis from a patient who has inadvertently used a hydrogen peroxide solution to clean and disinfect their lenses thinking it was a one-step solution. Placing hydrogen peroxide directly in the eye can be pretty uncomfortable!  Fortunately, after heavy irrigation and 24-48 hours of recovery, these patients can resume normal wear.  However, that illustrates that over-the-counter eye products are drugs and can have unfortunate and unintended side effects. In addition to soft contact lens solutions, there are cleaning and multi-step solutions for use with gas permeable rigid lenses.  Again, in the past there were separate cleaning and unique disinfection and conditioning solutions.  Now many are combined into one combination of cleaning-disinfection-conditioning solution.  Boston Simplex is an example.  Since gas permeable solutions are thicker, they are not appropriate for use with soft lenses. Next week, I will share some tips on selecting OTC moisturizing drops.
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