Industry news

ALERT: Stop using EzriCare Artificial Tears

The American Academy of Ophthalmology (AAO) has notified all its members of an 11-state outbreak of serious infections which the CDC has linked to Ezri Care Artificial Tears.

50 patients; one death

Fifty patients have been affected; thirty-eight are part of four “facility clusters”.

According to the AAO’s statement:

Patient outcomes include permanent vision loss resulting from ocular infection, hospitalization, and death of one patient with bloodstream infection.

Download AAO Statement

What is Ezri Care?

Ezri Care Artificial Tears are sold as a generic for Refresh Plus. However, they are 1% carboxymethylcellulose sodium which is actually more similar to Refresh Celluvisc. It is preservative-free, but sold in a standard multi-dose bottle, a dangerous practice about which the Dry Eye Foundation has been working hard to educate the patient community. (See Dr. Brown’s presentation on Frankenstein bottles.)

FDA warning letter to Sun Pharma

December 15, 2022 FDA Letter to Sun Pharma

Made public by FDA on January 10, 2023

IMPORTANT UPDATE: Sun Pharmaceutical is the maker of dry eye drug CEQUA, but CEQUA is manufactured in France, NOT at the Mumbai facility that the FDA’s letter was directed to. We posted the FDA letter due to the serious and ongoing nature of the problems described by the FDA at the Mumbai facility and the fact that FDA addresses their need to review their global manufacturing operations.


The FDA recently wrote to Sun Pharmaceutical about ongoing violations of Current Good Manufacturing Practices that they are failing to address despite having already been warned.

Excerpts:

1. Your firm failed to establish and follow appropriate written procedures that are designed to prevent microbiological contamination of drug products purporting to be sterile, and that include validation of all aseptic and sterilization processes (21 CFR 211.113(b))….

4. Your firm failed to thoroughly investigate any unexplained discrepancy or failure of a batch or any of its components to meet any of its specifications, whether or not the batch has already been distributed (21 CFR 211.192)….

5. Your firm failed to clean, maintain, and, as appropriate for the nature of the drug, sanitize and/or sterilize equipment and utensils at appropriate intervals to prevent malfunctions or contamination that would alter the safety, identity, strength, quality, or purity of the drug product beyond the official or other established requirements (21 CFR 211.67(a))….

…Significant findings in this letter demonstrate that your firm does not operate an effective quality system in accordance with CGMP. In addition to the lack of effective oversight of production operations to ensure reliable facilities and equipment, we found your QU is insufficiently resourced or enabled with authority to carry out its responsibilities. Furthermore, internal communications and systems were not implemented by management to ensure all levels of the company can effectively identify major quality risks so they are promptly escalated to senior management, whenever needed. You should immediately and comprehensively assess your company’s global manufacturing operations to ensure that systems, processes, and the products manufactured conform to FDA requirements.

Alcon launches Systane iLux2 in Canada

Alcon Elevates Dry Eye Care in Canada with Latest Innovation: Systane iLux2 MGD Thermal Pulsation System (Yahoo, November 15, 2022)

The Systane iLux2 treatment system is the only all-in-one, portable MGD device that can help Eye Care Professionals (ECPs) both evaluate their MGD patients and then effectively treat them through customizable control of heat and expression of their meibomian glands. To help educate patients on the benefits of this treatment, the Systane iLux2 now has advanced imaging capabilities used for meibography, enabling ECPs to capture white light and infrared photos of the meibomian glands, as well as high-definition (HD) video and images of the treatment process.