Putting the wrong kind of “drops” in your eyes can be a painful mistake

By guest blogger Michael R. Cohen: President of the Institute for Safe Medication Practices

It happens more often that you’d think. A patient accidentally puts drops into their eyes and later finds out that they picked up a dropper bottle that holds something other than eye drops.

One situation we’ve seen happen time and again as reported to our medication error reporting program  is when someone accidentally places ear drops into their eyes. When patients do that, they usually will quickly know that something is very wrong. The eyes will probably burn and sting right away, with swelling, redness, and blurred vision occurring soon after. They will probably need to have their eyes flushed with copious amounts of water or saline and may need to have warm or cold compresses applied. Some may require immediate care in the emergency department or eye clinic. In most cases, the injury to the eyes is temporary, but visual changes are a real possibility if something irritating gets in the eyes.

Mix-ups between eye and ear drops happen for several reasons and may also involve mistakes by health professionals, including pharmacists and nurses. Bottles can look alike and may be located right next to each other in the home or in pharmacies or clinics where medicines are stored. Medical terms associated with the ears (otic) and eyes (optic) both sound and look similar. People have sometimes chosen the wrong container or mixed up these terms. The fact that ears and eyes are relatively close together adds a “human anatomy factor” to the equation. Further risk is introduced by misuse of the term “eyedropper” to administer eye drops and eardrops as well as oral liquid medications. Many ear medicines use an “eyedropper,” which can subconsciously lead you to believe the medicine should be placed in the eyes.

Sometimes, eye drops can be safely used as ear drops because there are relatively few medicines for ears. However, ear drops should never be used in the eyes. Eye tissue is much more sensitive than ear tissue. Thus, eye drops are specially made to be gentle and germ-free, yet effective. In your home, ear drops that are used to clear wax out of the ears are sometimes confused with eye drops.

Putting ear drops into the eye is a problem, but other types of mix-ups involving the wrong kind of drops placed into the eye have also been reported. In one case a diabetic woman who couldn’t see well accidentally instilled drops meant for her blood sugar monitoring device, called a glucose meter, into her eyes. The bottle looked just like the eye drops she used for glaucoma. Both bottles had yellow caps and black lettering on the label.

In another case a woman grabbed what she thought was a solution of artificial tears and put a few drops into each eye. Her eyes immediately started burning and her vision became blurry. She then realized that she had actually grabbed a sample bottle of Elocon (mometasone) lotion that her doctor had given her to put on her irritated skin after her allergy shots. The woman had placed the Elocon bottle in a drawer right next to the eye drops.

Recently we’ve written about people who’ve accidentally placed super glue or nail glue into their eyes, thinking they had their eye drops in hand but instead sealing their eyelids shut. I wish Zsa Zsa Gabor’s husband, Prince Frederic von Anhalt, would have read the blog that I wrote earlier this year about similar situations.  Just last week he underwent surgery to pry his eyelids back open after doing the same thing!

Each of these individuals required medical care, but fortunately, no one lost their eyesight. Beware of bottles or tubes that resemble eye drops or ointments! To prevent mistakes like these, keep these products far away from your medicines! Always take a “time out” before using medicine drops of any sort to confirm that the correct bottle is in your hand. Forcing yourself to read the label out loud can help prevent mistakes. I’ve learned to do this myself.

As for mix-ups between eye drops and ear drops, keep eye drops and ear drops in their original cartons, as pictures of an eye or ear are often on these but not on the bottles. Never store eye drops and ear drops in the same location. Once you’ve used prescription ear or eye drops for as long as the doctor told you, discard the leftover supply so they’re not around to use by accident. Write the date you open any non-prescription drops on the label and throw the bottle away 4 weeks later. By then it may contain bacteria anyway. 

For information on ISMP's consumer web site go www.consumermedsafety.org

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