Abstract
Purpose :
Eye drops in ophthalmology clinics have artificial expiration dates of 14 and 28 days, significantly earlier than manufacturer labelled expiration dates. We hypothesized that these artificial expiration dates cause significant wastage. This creates an opportunity to implement waste reduction and cost saving practices.
Methods :
Multi-use ophthalmic drops planned to be discarded at 3 ophthalmology clinics across two centers in our health system were collected over three 14-day study periods. Residual medication volume was measured by pouring the contents of each bottle individually into a graduated cylinder or microcentrifuge tube with markings every 0.5ml. A 200µl adjustable volume pipette was used to measure any volume above the nearest 0.5ml marking. All medications had artificial expiration dates 28 days following opening, except proparacaine which artificially expired after 14 days. We noted an average overfill of 5% for new bottles and thus this “full” bottle volume was used for our calculations.
Results :
Over 6 weeks of collection, 297 bottles were discarded (Table 1). The average amount of medication left was 71.9% and bottles had on average 494 days between the date they were discarded and the manufacturer’s labeled expiration date. The most commonly discarded medications were proparacaine 0.5% (n=127), phenylephrine 2.5% (n=40), and tropicamide 1% (n=62). All proparacaine and tropicamide bottles were 15ml. For proparacaine, an average of 68.9% of the medication (10.8ml) remained unused and on average 520 days remained until the manufacturer’s expiration. For tropicamide, an average of 70.1% of the medication (11.0ml) remained unused and on average 526 days remained until the manufacturer’s expiration date. Phenylephrine came in both 2ml and 15ml bottles which had 66.8% (1.40ml) and 77.1% (12.1ml) of the medication remaining unused, with an average of 580 and 451 days until the manufacturer’s expiration date, respectively.
Conclusions :
This is the first study to report the wastage of ophthalmic eye drops in a clinic setting due to artificial expiration dates. We recommend establishing practices that utilize ophthalmic eye drops until the manufacturer’s labeled expiration date instead of artificial expiration dates. By doing so, ophthalmologists can help reduce healthcare’s carbon footprint and clinic costs without additional risk to patients.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.