Researchers at New York Eye and Ear Infirmary of Mount Sinai, presented evidence at AAO 2024 over the weekend, suggesting that simply adhering to the FDA-regulated expiration dates on eyedrop medications could not only reduce medication and plastic waste, but also save millions of dollars annually, and potentially prevent nationwide eyedrop shortages.

John Tan and his colleagues collected 297 discarded eyedrop bottles from three surgical sites within the Mount Sinai Health System over a 6-week period. They measured the volume of remaining medication in each bottle and estimated the number of drops that each represented, as well as the amount of plastic waste and cost waste.  The bottles were typically disposed of within 14-28 days of first use — almost a year and a half before the expiration dates listed on the bottles. On average, 72% of the medication remained in the discarded bottles. Had the manufacturer expiration dates been followed, the researchers estimate that 91% of bottles would have been completely used before being tossed and their health system could have saved $80,997 per year at those clinic sites.

“We were really surprised by just how much medication was being wasted,” said researcher John Tan in a press release. “We hope that clinics and providers use the FDA-regulated expiration date printed on each bottle. Considering the frequent medication shortages we have to contend with, this is one simple way to reduce the strain on our supply of ophthalmic medications.” 

Medical centers and practices throw away multi-use eyedrop bottles well before FDA-regulated expiration date out of extreme caution, noted the AAO in a press release. However, these self-imposed dates are not based on evidence and they do not prevent contamination, as infections from FDA-regulated dropper bottles used in clinical settings have not been reported when proper bottle storage and drop administration precautions are followed.