It’s a common scenario: you develop a red eye; you see your GP or pharmacist; you start using Chlorsig eye drops or eye ointment. Three weeks later, you still have a red eye – maybe even redder than it was to start. What’s going on?
Chlorsig eye drops and ointment – pretty good at what it’s supposed to do…but
Chloramphenicol, also called Chlorsig (or Chloromycetin), is a broad spectrum antibiotic drug available as eye drops or eye ointment. Chlorsig is readily available over the counter without a prescription. It is very effective against a wide range of bacteria and is useful in the treatment of certain bacterial infections of the eye, such as bacterial conjunctivitis. But it has no effect on viral eye disease, allergy or inflammation. In fact, it can make these conditions worse by its sheer presence, as it is quite toxic to the delicate tissues of the eye.
So, Chlorsig is actually worse than useless unless you happen to have a bacterial eye disease. Overuse of Chlorsig also allows bacteria to build up resistance, so the drug is less effective when it is really needed.
Why are my eyes red?
Red eyes are one of the most common reasons for a visit to the GP or pharmacy. Trouble is, neither your pharmacist nor your GP has a slit-lamp biomicroscope to examine your eye properly and make an accurate diagnosis. Your optometrist is the only primary care practitioner to have this piece of equipment available to examine every patient.
The first task is to diagnose the underlying cause of your red eyes. In adults, the most likely causes are viral conjunctivitis, seasonal allergy and dry eyes. Chlorsig is useless in treating any of these conditions, and its preservative as well as its effect on the eye only make things more uncomfortable.
Interestingly, viral conjunctivitis requires no treatment and clears up on its own with a week to ten days. If you throw Chlorsig into the mix however, you may still have a red eye several weeks later. That’s when patients often present at our practice.
Top tips if you have developed a red eye
- First, see your optometrist rather than your GP or pharmacist (who are likely to recommend the vastly over-prescribed chloramphenicol – AKA Chlorsig).
- Your optometrist will take a history and examine your eyes under high magnification to look for signs of allergy, foreign body, dryness or viral activity.
- In all cases there will be inflammation – your body’s way of dealing with an injury, and this always involves redness. Controlling the inflammation will automatically control the redness.
- Do NOT use vaso-constrictor eye drops (such as Visine or Murine) as these will leave your eyes redder than ever once you stop using them.
- Do apply a cold compress to decrease inflammation. A gel cold pack from the freezer works well.
- Avoid over the counter antibiotics (such as Chlorsig) unless you have been clearly diagnosed with bacterial conjunctivitis. (if you eyes have a watery discharge, it is very unlikely to be bacterial infection).
- Return to your optometrist after a week for review. Most minor infections will be on the mend by then.