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Are These Whitening Eye Drops Actually Safe?

Popular eye drops like Visine and Clear Eyes that claim to get out the red deliver on the promise–but usually only for a while. Then, they can have a rebound effect, resulting in more redness, which requires more drops... and on the cycle goes.

“You need more and more drug for the same effect because the body is trying to react to constant stimulation,” says Rahul Pandit, MD, an ophthalmologist with the Blanton Eye Institute at Houston Methodist Hospital.

Now, there’s a new (and potentially better) player on pharmacy shelves: eye drops called Lumify, approved by the FDA in late 2017.

Essentially, Lumify is similar to Visine in that it relieves redness and whitens the eyes, says Amy Lin, MD, associate professor in ophthalmology at the University of Utah Moran Eye Center. But it's different in that it doesn’t lead to the rebound redness some people get when they stop using the typical drops, she says.

Visine and similar drugs work by constricting blood vessels in the eye. They do this by toning down activity on the eye’s alpha-1 receptor. Lumify also constricts blood vessels, but it acts on a different receptor: alpha-2. According to Bausch & Lomb, which makes Lumify, targeting alpha-2 dilates small veins rather than small arteries (as targeting alpha-1 does), thereby avoiding the rebound effect.

“It’s in the same family [as Visine, Clear Eyes, and related medications], just a little bit more specific,” explains Laurie Barber, MD, a spokesperson for the American Academy of Ophthalmology.

Lumify is, in fact, a much lower concentration of a long-standing glaucoma medication called Alphagan, which is available by prescription. It decreases pressure on the optic nerve by constricting blood vessels.

“The dose that’s used for glaucoma is four to eight times what Lumify is, so it’s a safe drug,” says Dr. Lin.

Six studies involving about 600 participants reported a low risk for rebound redness when using Lumify. The longest of these studies lasted about seven weeks; the effects of the drops–which were usually given four times a day in the studies–lasted about eight hours.

The original Alphagan did come with side effects. For example, there’s a high incidence of allergic response to the active ingredient (brimonidine) in glaucoma patients, says Dr. Lin. People can also have reactions to the preservatives used. But the lower concentration may have fewer downsides, says Dr. Pandit, who has consulted for Bausch & Lomb.

Dr. Barber points out, though, that four times a day “is a lot of drops to be using.” (In fact, it’s “probably the maximum,” adds Dr. Lin.) “I’m concerned because when patients use it on a consistent basis, it masks a symptom we need to know about,” Dr. Barber says. “If a patient has red eyes and doesn’t know what’s causing them, they need to be seen by an ophthalmologist.” She’s also concerned that Lumify's label says it's safe for patients over the age of 5, even though studies were done only on adults.

That said, Dr. Barber’s “not against it yet, because I’m not able to evaluate it except from afar.” It may be okay for occasional use, say, once a month, if your eyes are red from fatigue.

Dr. Pandit on the other hand is more enthusiastic. “I’m really happy about it,” he says.

For years, patients have come to him wanting a way to get rid of redness. After all, red eyes are common, whether from allergies, staring at a glowing screen for prolonged periods, or wearing your contact lenses too long. Red eyes can also be a sign of more serious concerns, like conjunctivitis or even glaucoma. Some people even have a genetic predisposition to redness in their eyes, he adds.

“We can control the allergic reaction response but the redness portion is the most difficult thing to treat,” Dr. Pandit says. “Now we have something to offer them. This is the happy quotient we’ve been waiting for.”

Keep in mind that the medication has only been out for a few months, and there is often additional safety and efficacy information that sifts in as more and more people use any new drug. In other words, if you’re considering using Lumify, do so with the expert advice above in mind–and stay tuned for updates.

Source: https://www.health.com/condition/eye-health/eye-whitening-drops

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