For healthcare professionals

The effect of top­i­cal appli­ca­tions con­tain­ing Ben­za­lko­ni­um chlo­ride (BAK) and the rela­tion­ship with Ocu­lar Sur­face Dis­ease is well estab­lished, even in con­cen­tra­tions as low as 0.005%1

Patients with Dry Eye Dis­ease (DED), par­tic­u­lar­ly those who require fre­quent use of lubri­cants or oth­er top­i­cal ther­a­pies, should avoid ocu­lar lubri­cants that con­tain Ben­za­lko­ni­um chlo­ride (BAK).2

NICE guide­lines3 rec­om­mend the fol­low­ing for mod­er­ate to severe Dry Eye patients:

Con­sid­er preser­v­a­tive-free for­mu­la­tions if; the per­son is intol­er­ant of preser­v­a­tive in tear sup­ple­ments; has mod­er­ate to severe dry eye dis­ease requir­ing drops more than 4 times per day; is using mul­ti­ple pre­served top­i­cal med­ica­tions; or uses soft or hybrid con­tact lens.”

Pro­fes­sor Har­min­der Dua, one of the world’s lead­ing author­i­ties on the cornea and ocu­lar sur­face dis­ease explains some of the issues in the videos below: 

  1. Kaercher T et al. How the most com­mon preser­v­a­tive affects the Mei­bomi­um lipid lay­er. Orbit 1999; 18(2):89 – 97
  2. Gomes JAP et al. TFOS DEWS II Iatro­genic report, Ocul Surf 2017; 15:511 – 38
  3. NICE Guide­lines for Dry Eye syn­drome August 2017