Justice by the Eye Drop

How I Learned My Personal Battle with Eye Drops Was Worthy of a Court’s Consideration

This morning I woke up, rolled over to the bedside table where I keep my eyedrops, and squeezed a drop into each eye — and kind of all over my face. This is how I start every day, and also how I end the day, because I have dry eye syndrome and take prescription eye drops to make my eyes produce more and better tears.

If you’ve ever had pink eye or a host of other issues treated with eye drops, you’ve probably had the same experience: aim for the eye, hope for the best, expect to get your face wet. It always felt to me like too small a gripe to even bring up to my healthy-tear-producing friends, but on a daily basis I have to consider whether the drops I use throughout the day will smear my makeup, whether I should wear eye makeup at all, whether someone at work will think I was just crying. For people who use drops to treat other conditions, the effects can be much more serious: medicated eye drops running down their cheeks can cause allergic reactions or skin pigmentation, and absorbing medicated drops through the wrong part of the eye can increase the risk of toxic side effects.

And prescription eye drops, like so many medications, are expensive. The drops I use have a sticker price of nearly $450 for a 30-day supply — about $5000 a year. When I had eye surgery, also to help my eye condition, just one of the drops I needed for recovery is priced at $183 for 2.5 milliliters without insurance (for reference, an individual coffee creamer is 11 milliliters). So I do think about the cost when my medicated drops cascade out of my eye, or the bottle runs out too quickly.

Apparently I’m not the only one, and it looks like it’s not our fault.

Pharmaceuticals are making eye drops too big — 39 microliters on average — when decades of scientific research (largely funded by the drug companies themselves) have concluded that drops of about 15 microliters are as effective as treatment, and reduce waste, risk of side effects, and the cost to insurers and consumers. And scientists have known how to make a smaller dropper tip since 1985–32 years ago. So why aren’t pharmaceuticals making the smaller dropper that consumers want and companies can clearly produce?

As a daily eye drop user, even after reading these damning facts, I figured this is just how our world works. My tweet when I read the article said as much:

But I’m happy to say I was wrong. Consumers can do something. In fact, they are.

As I learned from a coworker who saw my tweet, Public Justice, the organization I joined less than a month ago, is leading the charge in the eye drop case. Leah Nicholls, an attorney at Public Justice, has been fighting this issue in the courts on behalf of people just like me. And on the day these stories dropped, she won an appeal in the eye drop case that has implications for Americans beyond just the dropper community.

In October, I joined Public Justice’s team as their outreach manager to create ways to meaningfully engage with communities around the issues that Public Justice has been litigating for over three decades. So I was already familiar with a large part of their work on protecting civil rights and liberties, defending the environment from damaging practices by factory farms and big coal companies, and much more. But I didn’t realize the extent to which Public Justice is fighting for regular people —consumers just like me.

And it’s a good thing in more than one way. The case that Public Justice is fighting involves glaucoma patients who are suing drug manufacturers for packaging prescription eye drops in bottles that make drops that are two or three times the recommended size. The larger drops mean the patients have to buy more medication than they need. It also puts them at increased risk of adverse side effects. For these glaucoma patients, the case isn’t about their dissatisfaction with a product, as one judge suggested while comparing them to cat owners complaining about breeders who tell them to purchase kitty fountains. It’s about whether or not they’ll go blind.

But Public Justice’s work is even more farsighted than that. While I’m personally excited that anyone else cares about eye drops staying in my eyes, Public Justice attorney Leah Nicholls was interested in the case because of its potential implications for any consumers bringing lawsuits against big businesses.

When glaucoma patients brought this case, the pharmaceuticals in question responded by attempting to persuade the court that the patients couldn’t demonstrate enough proof or harm to be able to even bring the case to court — despite the copious scientific evidence that they knew existed. Basically, the corporations’ argument is that even patients who had to buy excess medication and risk additional side effects weren’t injured enough to even get their claims through the courthouse doors. If the courts were to agree, it would make it harder for all consumers of prescription drugs to bring lawsuits when they get screwed over, and easier for big businesses to ignore sound science in favor of profits.

Thankfully, Public Justice is working hard to make sure that the courts are open for us when we’ve been wronged by pharmaceuticals or other entities bigger and better staffed than we are as individuals. From dismantling “ag-gag” laws that criminalize people who attempt to expose the shocking realities of the animal agricultural industry, to holding mega-dairies and power plants accountable for contaminating communities’ water, to protecting Americans’ ability to bring class action lawsuits, Public Justice makes sure ordinary people can access the courts and hold corporations and government entities responsible when they mess up.

I was blown away to realize my new workplace is fighting for me in ways I didn’t even know. It’s fighting for you, too. I invite you to stay in touch as we take these fights forward. Learn more:

• follow Leah Nicholls and Public Justice on Twitter
• sign up for emails from Public Justice
• support Public Justice’s work