No need to ban toxic eye drops, say ophthalmologists

Danish ophthalmologists have pushed back against calls to ban over-the-counter eye drops containing the preservative benzalkonium chloride (BAK), despite concerns raised earlier this week by a leading eye specialist and a patient association.

Peter Jeppesen, an ophthalmologist and chair of the Danish Ophthalmological Society, told DR that while he prefers preservative-free drops, the active ingredients—not the preservatives—are often the source of irritation. He also noted that BAK-containing drops are significantly cheaper, costing around 50 kroner compared to 160–180 kroner for preservative-free alternatives.

“I have patients who specifically ask for the ones with preservatives because they’re much cheaper—up to six times cheaper,” Jeppesen said.

Jesper Hjortdal, a clinical professor and senior consultant at Aarhus University Hospital’s department of ophthalmology, echoed the sentiment, stating that occasional use of BAK-containing drops is unlikely to cause harm. “I think it can be fine for many years without health-damaging effects,” he said.

Both doctors emphasized patient choice and proper guidance from pharmacies and retailers. The Danish Medicines Agency told DR it tightened rules in 2023 to reduce the use of prescription BAK-containing drops but has no plans to restrict over-the-counter sales.

Three parties in the Folketing have urged Health Minister Ida Auken to explore a potential ban on over-the-counter BAK-containing eye drops. The minister has not responded to DR’s interview requests.