CHICAGO, Ill. — It was no surprise to ophthalmologists at New York Eye and Ear Infirmary of Mount Sinai that multiuse eye drop bottles were routinely tossed in the trash well before the Food and Drug Administration (FDA)-regulated expiration dates printed on the bottle. But they were stunned by the results of their study quantifying the waste. On average, 72 percent of the medication remained in the bottles at the time the drops were discarded.
The findings, presented this week at AAO 2024, the 128th annual meeting of the American Academy of Ophthalmology, suggest that simply adhering to the FDA-regulated expiration dates could not only reduce medication and plastic waste, but also save millions of dollars annually, and potentially prevent nationwide eye drop shortages.
“We were really surprised by just how much medication was being wasted,” said researcher John Tan of the New York Eye and Ear Infirmary of Mount Sinai. “We hope that clinics and providers use the FDA-regulated expiration date printed on each bottle. Considering the frequent medication shortages we have to contend with, this is one simple way to reduce the strain on our supply of ophthalmic medications.”
Academic medical centers and health care systems throw away multi-use eye drop bottles well before FDA-regulated expiration date out of extreme caution. However, these self-imposed dates are not based on evidence and they do not prevent contamination, since infections from FDA-regulated dropper bottles used in clinical settings have not been reported when proper bottle storage and drop administration precautions are followed. FDA-regulated expiration dates are based on extensive testing of the drop in the marketed container with appropriate preservatives.
To conduct the study, Tan and his colleagues collected 297 discarded eye drop bottles from three surgical sites within the Mount Sinai Health System over a six week period. They measured the volume of remaining medication in each bottle and estimated the number of drops that each represented, as well as the amount of plastic waste and cost waste.
The bottles were typically disposed of within 14-28 days of first use. That’s almost a year and a half before the expiration dates listed on the bottles. On average, 72 percent of the medication remained in the discarded bottles. Had the manufacturer expiration dates been followed, they estimate that 91 percent of bottles would have been completely used before being tossed and their health system could have saved $80,997 per year at three clinic sites.
The American Academy of Ophthalmology is committed to reducing medicine’s carbon footprint and making ophthalmology more sustainable for the future by forging strategic partnerships, advocating to policymakers and creating awareness. Learn more here.
About the American Academy of Ophthalmology
The American Academy of Ophthalmology is the world’s largest association of eye physicians and surgeons. A global community of 32,000 medical doctors, we protect sight and empower lives by setting the standards for ophthalmic education and advocating for our patients and the public. We innovate and support research to advance our profession and to ensure the delivery of the highest-quality eye care. Our EyeSmart® program provides the public with the most trusted information about eye health. For more information, visit aao.org.
