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Eyedrops 101: What They Can—and Can’t—Do for Your Eyes · Flourish- A Prisma Health Podcast

• 0:00
  Scott Webb: Today I have the pleasure of speaking with ophthalmologist, Dr.
• 0:02
  Alejandro OT from Prisma Health.
• 0:05
  We will talk about eyedrops 1 0 1, what they can and can't do for your eyes.
• 0:09
  I.
• 0:11
  Scott Webb (Host): This is Flourish, the podcast brought to you by Prisma Health.
• 0:15
  I'm Scott Webb.
• 0:16
  Scott Webb: Doctors, nice to have you here today.
• 0:17
  As I mentioned in the intro there we're talking eyedrops 1 0 1.
• 0:20
  You know what, they can do what they can't do for our eyes.
• 0:23
  So let's start there.
• 0:24
  Do eyedrops help protect our vision?
• 0:27
  Dr. Alejandro Espaillat:
• 0:27
  Well, eyedrops are one of the most commonly used medications in medicine.
• 0:32
  They can treat dryness, allergies, glaucoma, infections, and inflammation.
• 0:38
  But they're not magic.
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  They work best when used correctly And for the right diagnosis, and sometimes they
• 0:46
  can even make things worse if misused.
• 0:51
  Scott Webb: Interesting.
• 0:51
  Right?
• 0:52
  They're not magic.
• 0:52
  Uh, that's an important point to make today, And we don't want to misuse them.
• 0:56
  So then let's talk about some of the eye problems.
• 0:58
  If, if they won't protect our vision per se, but what else can they help with?
• 1:01
  Is it, , outdoor allergies?
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  Anything else?
• 1:05
  Dr. Alejandro Espaillat:
• 1:05
  Well, they can help for many things.
• 1:07
  For example, artificial tears for dry eyes.
• 1:10
  They can relieve dryness.
• 1:12
  They can improve comfort.
• 1:14
  They can stabilize tear film, help, blurry vision for dryness.
• 1:18
  But what they can do is that they cannot cure dry eye disease.
• 1:23
  They cannot fix severe inflammation or replace medical
• 1:27
  treatment in advanced cases.
• 1:30
  So artificial tears are like moisturizers for your eyes.
• 1:34
  They're helpful, but not a cure if there's underlying disease.
• 1:39
  allergy drops.
• 1:40
  They can reduce itching, calm redness for from allergies and
• 1:44
  prevent symptoms if used early.
• 1:47
  What they can't do, they cannot treat any infections or fixed
• 1:51
  chronic redness for other causes.
• 1:54
  So if your main symptoms is itching, well, you have to think of allergy,
• 1:59
  Scott Webb: Okay.
• 2:00
  Dr. Alejandro Espaillat:
• 2:00
  uh, now redness and, relief drops.
• 2:03
  To get the red out, they can temporarily reduce redness, but
• 2:07
  they can treat the cause or be used daily for long-term safety.
• 2:12
  They can cause rebound redness, dependency, or worse of the dryness.
• 2:17
  Redness drops are cosmetic, not , therapeutic and that's,
• 2:22
  actually a very important thing that you need to really recognize.
• 2:25
  So, redness drops are cosmetic and not therapeutic.
• 2:29
  And we also have medications to control inflammation like steroid, eyedrops.
• 2:34
  And they can treat inflammation, they can calm severe allergies
• 2:38
  and they can help after surgery, but they cannot be used casually.
• 2:43
  They usually cannot be used for long-term without supervision because they can
• 2:47
  increase the eye pressure and lead to other diseases like glaucoma or cataracts.
• 2:53
  We also have antibiotic eye drops, and they can treat bacterial infections.
• 2:58
  What they cannot do is they, they cannot treat any vital pink eye or
• 3:02
  speed up any vital conjunctivitis.
• 3:05
  So most pink eyes are vital and antibiotic eye drops don't kill viruses.
• 3:12
  Uh,
• 3:12
  Scott Webb: Hmm.
• 3:13
  Dr. Alejandro Espaillat:
• 3:13
  we also use eye drops for, uh, treatment of the disease called glaucoma.
• 3:18
  And the problem is that in this disease, the intraocular
• 3:22
  pressure tends to increase.
• 3:24
  So these eyedrops, we use them to lower the eye pressure, to slow vision
• 3:29
  loss and to preserve sight, but they cannot restore the vision that has
• 3:34
  already been lost or cure glaucoma.
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  So glaucoma drops, they protect the vision you still have, but
• 3:42
  they don't bring back what's gone.
• 3:47
  Scott Webb: Interesting.
• 3:48
  Yeah.
• 3:48
  'cause I was, I wanted to follow-up and ask you like, are there actually any
• 3:51
  eyedrops that, you know, improve vision or maybe reduce the need for glasses?
• 3:57
  Dr. Alejandro Espaillat:
• 3:57
  Well, they're very common misconceptions and, like for example,
• 4:01
  can I use someone else's drops?
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  Well, no, drops are prescribed for a specific diagnosis.
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  Using the wrong drop can delay treatment or even cause harm.
• 4:12
  Also people ask, are natural or herbal drops safer?
• 4:17
  Well, no.
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  Natural doesn't always mean safe.
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  Anything you put in your eye needs to be sterile and appropriate for the condition.
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  And the same question that you just asked, if eye drops can improve
• 4:29
  vision, well, only if blur is from dryness, inflammation, or pressure.
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  They cannot fix cataracts or macular degeneration And the need for glasses.
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  So eyedrops can improve vision when the problem is related
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  to the surface of the eye.
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  But they can't replace any surgery or glass.
• 4:50
  This,
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  Scott Webb: Right.
• 4:53
  I've often wondered this, doctor, is it okay to use eyedrops every day?
• 4:56
  I feel like I see people use them, you know, routinely, and
• 4:59
  I always wonder, is that okay?
• 5:01
  Is that right?
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  Dr. Alejandro Espaillat:
• 5:03
  well, it all depends on the diagnosis And the reason why.
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  If you're using the eyebrows for lubrication due to dry eyes,
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  yes, you can use those eyedrops every day up to four times a day
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  without any problem whatsoever.
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  , If you're using the eye drops for glaucoma, yes, you must use your eye drops
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  every day according to the prescription And the indications So, It all depends for
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  the reason why you're using the drops for.
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  Scott Webb: Gotcha.
• 5:32
  And Doctor, how about, over-the-counter eyedrops?
• 5:35
  You know, you go to the drugstore and you see all these different options and
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  my head starts spinning a little bit.
• 5:40
  Just wondering from an expert, like, are they safe?
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  The over-the-counter stuff?
• 5:44
  Dr. Alejandro Espaillat:
• 5:44
  Yes, as long as they are from a reputable brand.
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  There were some reports recently of some, eye drops that were contaminated
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  And that led to, , lots of issues.
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  But those were from a brand that was not reputable and were not sterile.
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  So you have to ask your eyecare provider, which is the correct brand or brands
• 6:07
  that, could benefit you for lubrication, and to treat the dry eyes mostly.
• 6:15
  Scott Webb: Yeah, I was gonna ask you if folks ever bring their
• 6:17
  eyedrops in and, and ask you say, Hey, I bought these, are these okay?
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  Like, is that something that folks should do?
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  Is bring them with us when we go to the doctor?
• 6:24
  Dr. Alejandro Espaillat:
• 6:24
  Yes.
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  If you are a patient and you come to your eyecare provider, you must always bring
• 6:29
  your eyedrops, the ones that you're using at home, , regardless of the reason.
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  That would be the best timing for you to ask, if you should continue
• 6:39
  using those drops or if you should change them or stop them.
• 6:44
  Scott Webb: Yeah, and doctor, I'm sure a lot of us have experienced this where
• 6:47
  we have red eyes or you know, eyes are being irritated And we make an appointment
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  And we come in And then while we're there, even though they were super red
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  the day before, they're not red anymore.
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  Any sense of why that happens?
• 6:58
  I.
• 6:59
  Dr. Alejandro Espaillat:
• 6:59
  It could be, again, for many reasons.
• 7:01
  It could be from simple dry eyes, to allergies, to inflammation, to trauma.
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  So, It is very important to also ask about other symptoms
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  like pain or light sensitivity.
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  Or irritation or drainage.
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  So Those are the things that you will discuss with your eyecare
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  provider in order to find the right and correct diagnosis.
• 7:22
  Scott Webb: Sure.
• 7:24
  And doctor, how about the sun?
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  A lot of us spend time in the sun.
• 7:27
  I've been wearing sunglasses most of my life, whether it was, you know, to
• 7:31
  protect my eyes or because they look cool or keep the sun outta my eyes.
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  But is the sun bad for our eyes?
• 7:37
  And if so, would eyedrops make any difference?
• 7:40
  Dr. Alejandro Espaillat:
• 7:40
  Well, the sun radiates, ultraviolet light A, B, and C.
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  Ultraviolet light A and B can actually harm the eyes, not only causing dry
• 7:50
  eyes, but also affecting the retina.
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  And in some patient's leading to something called macular degeneration,
• 7:57
  as well as the formation of cataract.
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  So you have to have some, some protection with polarized sunglasses that would
• 8:07
  deviate this sun, sun ray, in a way that would not be harmful to your eyes.
• 8:12
  So, yes, I, deeply believe that you have to use Sun Protect.
• 8:16
  Scott Webb: sure.
• 8:17
  How about eyedrops and contact lenses?
• 8:19
  Do those things go together and if so, how do they work together?
• 8:22
  Dr. Alejandro Espaillat:
• 8:22
  A contact lens.
• 8:24
  It is a very important, part of the tools that we have in order to
• 8:28
  provide good vision for patient's, but they are, in reality a foreign
• 8:32
  body that you are applying and putting in contact with your eyes.
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  So they need to be properly fitted as well as.
• 8:40
  You have to clean them properly to prevent any, , infections, which are
• 8:44
  very common in patient's with contact lens use, as well as, , severe dryness
• 8:49
  and irritation and inflammation.
• 8:51
  If you wear contact lenses, you have to use them according to the manufacturing
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  prescriptions, as well as the way that we're instructed to be used by your IK
• 9:01
  provider, and you have to keep them clean.
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  Plus, you need to use, regular lubricating eyedrops in order
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  to, facilitate and prevent any foreign body sensation in your arm.
• 9:12
  Life.
• 9:13
  Scott Webb: Yeah.
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  I am sure, doctor, there are folks out there that use multiple kinds
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  of drops, types of drops every day.
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  Maybe they, allergy, prescription, whatever it might
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  be, and provided that's okay.
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  Do they need to space them out and if so, how should they be spaced out?
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  Dr. Alejandro Espaillat:
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  Well, it is important to remember that as we grow older,
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  we tend to produce less tears.
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  The quality of our tears is not the same.
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  And we tend to, also use medication for other reasons.
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  And all of those things can lead to severe dryness.
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  Especially patient's who are for, with medication for high blood pressure
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  or medications for glaucoma,, they can induce some toxicity to the eye.
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  So dry eyes is a severe, condition that would.,
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  Affect, lots of people, especially here in South Carolina, during
• 10:05
  the winter And the spring month.
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  And, so using lubrication accordingly, it, it is extremely important,
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  but you have to also use the right lubricating drops because the tears.
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  are formed of a layer of, , water, mucus, and oil.
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  That's the composition, the normal composition of the tears.
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  So if you're missing one of those, elements, then the dryness would be due
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  to that particular element being missed.
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  So you have to use the artificial tears that would provide that
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  missing element and not just
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  Scott Webb: Right, so we can use different types of drops in the same-day.
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  Is there any recommendation for spacing them out?
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  Should we do them one right after the other, or do we need to allow
• 10:51
  a little bit of time in between?
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  Dr. Alejandro Espaillat:
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  You, you can use different drops every day.
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  For example, patient's with glaucoma, they use glaucoma drops, and at the
• 10:59
  same time they use artificial tears.
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  For lubrication, usually you have to space the drops about
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  three to five minutes in between.
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  Because otherwise if you do it much closer, then one will wash the other one.
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  So, you have to apac, them at least, three minutes in between.
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  Sometimes you have to shake the bottle well and, follow
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  your instructions accordingly.
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  Scott Webb: Yeah.
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  And in terms of the instructions, doctor, I feel like I've never been
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  particularly good at, using eyedrops.
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  I always feel like I get more in one eye than the other eye,
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  or I miss one eye entirely.
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  Is there a correct way, if you will, to apply eyedrops to
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  ensure maximum, effectiveness?
• 11:40
  Dr. Alejandro Espaillat:
• 11:40
  Absolutely the best And the proper drop technique, usually,
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  starts with washing your hands.
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  Then you tilt your head back.
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  You pull your lower lid down And then you instill one drop only.
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  Then you close your eye.
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  Gently wait 10 seconds, and most of the time if you're using medication, you can
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  press the inner corner, for one minute.
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  That would guarantee that the eye drop will stay there
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  for the time that it needs.
• 12:14
  Scott Webb: Right.
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  Dr. Alejandro Espaillat:
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  One drop is enough.
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  You do not need to instill more than one drop at the same time.
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  The, I can't hold more than that, so one drop is enough.
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  So you don't need to be instilling like two, three drops at the same
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  time thinking that more is better.
• 12:31
  No.
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  Scott Webb: Yeah, and I'm sure we've all been there thinking, you
• 12:34
  know, whether it was dry eye or whatever it was, more is better.
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  But as you say, your eye can only hold so much.
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  So more isn't better.
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  It's been great to have you here, Dr.
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  Great.
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  To have your expertise.
• 12:44
  Just final thoughts, takeaways.
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  When we think about using eye drops, when, how, why?
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  All that good stuff.
• 12:50
  Dr. Alejandro Espaillat:
• 12:50
  When to see the doctor.
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  Well, you have to, the red flags are usually pain license
• 12:55
  sensitivity, sudden vision loss.
• 12:57
  Trauma or symptoms lasting more than one week or thick discharge.
• 13:03
  If it hurts or affects your vision significantly, don't self-treat.
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  You have to get, evaluated by a an eye care provider.
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  So, eye drops are powerful tools when used correctly.
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  The key is matching the right drop to the right diagnosis.
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  When in doubt, don't guess your eyes are too important.
• 13:25
  Scott Webb: Right, way too important.
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  As you've said here today, eyedrops are, generally safe and
• 13:30
  effective, but they're not magic.
• 13:31
  When in doubt speak with our provider.
• 13:33
  Maybe bring 'em with, say, Hey, doc, are these okay?
• 13:35
  So I appreciate everything today.
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  Thank you so much.
• 13:38
  Dr. Alejandro Espaillat:
• 13:38
  Thank you very much, Scott.
• 13:39
  Have a great day.
• 13:40
  Host: For more information and other podcasts just like this one, head on
• 13:44
  over to prismahealth.org/flourish.
• 13:46
  This has been Flourish, a podcast brought to you by Prisma Health.
• 13:49
  I'm Scott Webb.
• 13:50
  Stay well.