Chlorsig / Chloramphenicol
Chlorsig is a broad spectrum antibiotic and is used to treat a range of eye infections. It is available in the form of eye drops and ointment. Unfortunately they are grossly overused, and this has only become worse since they became available over the counter.
Most eye irritations are not caused by bacterial infections. The majority of conjunctivitis and eye inflammation is caused by allergy, dryness or viral eye infections, none of which will be treated by using this medication.
No time to read the whole article? Download our free Quick Guide to Treatment for Red Eyes for some essential tips.
Aplastic anaemia risk?
Chloramphenicol is the active ingredient used in the eye drops and ointment. This drug is also used in oral and intravenous forms for systemic bacterial infections, when others have failed. In the USA, Chlorsig eye drops are purposely NOT prescribed because the active ingredient, chloramphenicol, can rarely cause a serious systemic condition called aplastic anaemia. This data, however, comes from studies of the drug used in high-concentration systemic form - i.e. where it is prescribed as oral medication or injections for serious bacterial infections. In Chlorsig eye drops, the active ingredient is extremely dilute, and considered harmless by hundreds of thousands of doctors in other countries including Australia and the UK.
If chloramphenicol in eye drop form did in fact cause aplastic anaemia, we would expect that the incidence of this disease would be significantly greater in Australia and the UK, where its use is very significant. This is NOT the case. In fact there is no difference in the incidence of aplastic anaemia between Australia and the USA even though at least 5 million bottles of these eye drops are sold every year.
When is Chlorsig indicated?
If you have been diagnosed with a bacterial eye infection that is not related to contact lens wear, this medication is a good choice as it is effective against a broad range of bacteria. It is also a good choice where the eye has sustained a scratch and needs to be protected from possible infection. This is called prophylactic use, and is also used after eye procedures to protect the eye from harmful pathogens.
Chlorsig eye drops or ointment?
If the eye has been scratched, e.g. by a branch or a baby's fingernail, your optometrist may prescribe the ointment (rather than the drops), as it is also an excellent lubricant and will prevent your eyelid from sticking to the surface of your eye while you sleep. It will also protect the eye against any bacterial infection.
When are these eye drops and ointment NOT indicated?
If you don't have a bacterial infection in your eye, then Chlorsig will not help. Chances are, even if you have an eye infection, it may have a viral (or fungal) cause, rather than bacterial conjunctivitis or keratitis (inflammation of the cornea).
Most irritations are not infections at all, and are as a result of inflammation. This may be autoimmune (such as in the case of acute inflammation like uveitis) or it may be an allergic reaction to seasonal allergens such as pollen or grasses.
Dry Eyes also cause redness and inflammation and will not be helped by this type of eye drop.
In fact, these eye drops are preserved, and the preservative commonly contributes to the irritation and inflammation.
If you have DRY, IRRITATED eyes, download our free eBook for more information on the most successful treatment.
Now the most important point!!
Chlorsig eye drops and ointment should not be used as a treatment for any contact lens-related red eyes. In the worst case scenario if a bacterial infection is involved, 70% of the time it will be a bacteria called contact lens-related pseudomonas keratitis. This eye condition does not respond to chloramphenicol eye drops or ointments. There are cases of eyes going blind because of inappropriate use of this drug when contact lenses are involved.
How to avoid unnecessary use of chloramphenicol eye drops
Avoid using over-the-counter Chlorsig unless you have been specifically advised to get it by your therapeutically endorsed optometrist or ophthalmologist. If you have a red, irritated, inflamed eye, where possible see an eye care practitioner rather than a GP.
Eye care practitioners (optometrists and ophthalmologists) are equipped with Slit-Lamp Bio-microscopes to closely examine your eye under high magnification and adequate light. They can observe classic signs that distinguish bacterial infections from other, non-bacterial infections (such as viruses) and from non-infective causes.
Where possible, choose an optometrist who is therapeutically endorsed, as not only will they have had in-depth training in distinguishing between different eye diseases, they will also be able to prescribe the appropriate eye drops to treat your eyes.