First recalled in February 2023, the pseudomonas aeruginosa outbreak among EzriCare Artificial Tears products continues to spread—and has now impacted 81 patients in 18 states, according to a May update by the Centers for Disease Control and Prevention (CDC). This is a 13-person increase from the agency's last update in April. To date, four people have died in connection to the outbreak and several people have lost their eyesight because of it.

Pseudomonas aeruginosa is a drug-resistant germ that can cause aggressive infections in the eye, leading to things like loss of eyesight or even death.

Benjamin Bert, MD, an ophthalmologist at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, says that because people typically need to have direct ocular contact with pseudomonas aeruginosa to develop an infection, it’s not the kind of thing most people are at risk for on a daily basis. Because artificial tears are designed for direct eye contact, however, this outbreak has put users in a very dangerous situation.

“It’s an unfortunate event where we have this double whammy of the contamination event with a very pathologic bacteria,” says Bert.

People who are using EzriCare Artificial Tears should immediately discontinue use, and consult an eye doctor if they are at risk for infection or have developed one. Signs of an early infection could include irritation, a foreign body sensation, decreased vision, vision sensitivity, or pain, he says.

Bert adds that, for localized infections, people can expect most treatments to be in the form of a medicine. In cases where symptoms have spread to other parts of the body and a person is developing symptoms like fever, chills, weakness, or neurologic deficits, hospital intervention for IV treatments may be necessary, he adds.

People who have extreme reactions may want to seek care at the emergency room, however, ERs may not have the capability to conduct culture testing for the pathogen, so those with more localized symptoms should seek help from an eye doctor first if one is available, he adds. If not available, he advises seeking ER treatment for that as well.

“If it's locally contained to symptoms of the eye or around the eye, it may be more prudent to seek care with an eye doctor,” he says.

EzriCare is a generic version of the brand Refresh, so people who like the consistency and feel of EzriCare should be able to find the same results from the brand name, he says. If not, there are several brands of artificial tear products, so people have other options to choose from even if they are not a perfect fit, he adds.

“Dry eye affects a large majority of the population. It's something that increases in frequency as we age and with the amount of time that we all spend on screens,” says Bert. “Just like we have moisturizers available for our skin when our skin gets dry, artificial tears are moisturizers for the eyes.”