The Preservative Freedom Coalition (PFC) is dedicated to bringing the importance of preservative-free treatments into focus and encouraging patient-centered discussions that inspire changes in habits to prioritize eye health. Thank you for supporting Preservative Freedom and demonstrating your dedication to lifelong ocular health for all.
In this edition
Patient Education on Preservatives
Preservative Freedom Activity Snapshot
Coalition Founding Member Spotlight: Jacob Lang, The Intrepid Society
About Preservative Freedom
Patient Education on Preservatives
As ophthalmologists and optometrists, time is never on our side. There is so much we could educate patients on and discuss during consultations. With so many touchpoints across the clinic, there is an opportunity to build a culture of education that empowers patients, and it is up to us to ensure they have access to education through reliable sources – when and how they need it.
Improving patients’ understanding of the topic encourages meaningful conversations in the clinic and beyond. This open dialogue about concerns and preferences regarding preservatives in eye care products empowers patients to make informed decisions. It empowers them to be advocates for their own ocular health.
"In today's fast-paced healthcare environment, patient education often falls short. I see patients every day that ask me why their previous eye doctor has never told them what I am educating them about. We are better than that! Actively involving patients in their care and treatment plans fosters ownership, responsibility, and confidence," said Jerry Robben, OD, Chief Optometrist at Bowden Eye & Associates and Founding Member of Dry Eye University. "No relevant topic is too minor to overlook. By educating our patients about the benefits of preservative-free options, we empower them to make informed decisions about their eye health, enhancing their overall treatment experience. This is what the Preservative Freedom Coalition stands for.”
Personalized coaching and education have been shown to improve adherence to glaucoma medications [1]. While it may not be possible to provide this level of individualized counselling, there are ways we can maximize education across the clinic.
Simple language: Explain the purpose and benefits of preservatives in simple language rather than use jargon or complex medical terminology.
Visual aids: Charts and diagrams can help explain the impact of preservatives in a visual and easy-to-understand way.
Brief conversations: Introduce the topic of preservatives during the visit when relevant, such as when prescribing medication, and address any relevant concerns or misunderstandings.
Follow-up resources: Direct patients to reliable online resources where they can learn more about preservatives at their own pace and/or provide materials to take home.
Staff training: Ensure all clinic staff are knowledgeable about preservatives so they can assist in educating patients and answering questions proactively and reactively.
To support patient education the PFC has developed an information sheet on preservatives in eye treatments.
Preservative Freedom Activity Snapshot
Guidelines support preservative-free treatment in glaucoma The American Optometric Association (AOA) released the first edition of the Evidence-Based Clinical Practice Guideline for the care of patients with Primary Open-Angle Glaucoma (POAG). We are pleased to see the inclusion of preservative-free recommendations, particularly for patients with ocular surface disease (OSD). The PFC responded to the AOA call for feedback when these guidelines were in development and highlighted the need for clarity and information about preservative-free.
We commend the AOA for its clarity regarding preservatives. This is a significant step forward in contextualizing the damage that can be caused by preservatives and the potential opportunities for preservative-free care. We encourage other organizations to prioritize this important information and continue to build understanding across the eyecare community and patients.
The next generation of ophthalmologists say EYE
Real World Ophthalmology (RWO) After Dark at AAO this past October was a great opportunity for the PFC to raise awareness. We engaged students, residents and ophthalmologists new to the industry in an open dialogue about Preservative Freedom. Welcome and thank you to the many who said EYE to our pledge!
Coalition Founding Member Spotlight
Jacob Lang, Vice-President of the Intrepid Eye Society
Dr. Jacob Lang, OD FAAO, is the medical director of dry eye services and ocular disease residency programs at Associated Eye Care in Hudson, WI, and Stillwater, MN. He is vice president of the Intrepid Eye Society and a member of the American and Minnesota Optometric Associations. He is actively involved in clinical research and consulting within the eyecare industry.
Why do you think it is essential to have conversations about preservatives with patients and educate them on this topic?
As an optometrist specializing in cornea and dry eye disease, I see firsthand how preservatives, particularly those in eye drops, can exacerbate ocular surface issues. Many patients are unaware that these ingredients, such as benzalkonium chloride (BAK), can disrupt the delicate balance of the tear film, cause inflammation, nerve damage, and worsen symptoms of dry eye or other ocular surface conditions. Educating patients about preservatives empowers them to make informed decisions about their eye care, helping to improve their comfort, compliance, and overall ocular health. These conversations are crucial for preventing long-term damage to the cornea and ocular surface.
How do you talk about preservative-free with your patients?
I use simple analogies to explain the impact of preservatives on the eye. For example, I liken the ocular surface to a lawn—preservatives are like harsh chemicals that, when used repeatedly, can harm the grass (ocular surface). I discuss the importance of using preservative-free products, especially for patients with chronic conditions like dry eye, glaucoma, or allergies, where frequent drop use is required. I also show them options for preservative-free formulations and emphasize how these products can enhance their comfort and minimize irritation over time.
What could a preservative-free future in eye care mean for patients?
A preservative-free future in eye care could revolutionize the patient experience by reducing the risk of irritation, inflammation, and long-term damage to the ocular surface. It could mean greater comfort, and therefore potentially greater compliance or adherence, especially for patients with chronic conditions. This could also lead to improved treatment outcomes for diseases like glaucoma and dry eye, where preserving the health of the ocular surface is critical. Additionally, with advancements in preservative-free packaging technology, patients would no longer have to compromise between convenience and safety. Such a future would signify a shift toward more patient-centered care and a healthier, more sustainable approach to managing ocular surface diseases.
Why did you join the Preservative Freedom Coalition?
I joined the Preservative Freedom Coalition because I am passionate about advancing the standard of care for patients with corneal and ocular surface diseases. This coalition aligns with my commitment to advocating for preservative-free options, educating patients, and raising awareness about the long-term effects of preservatives on ocular health. Collaborating with like-minded professionals allows me to contribute to research, innovation, and patient education that supports a preservative-free future. By being part of this coalition, I can amplify the message that preservative-free is not just a trend but a critical step toward better outcomes in eye care.
About Preservative Freedom
Our mission is to bring the importance of preservative-free treatments into focus and encourage patient-centered discussion that inspires a change in habits that prioritizes future eye health.
We focus on three pillars to drive meaningful change:
If you or your organization would like to get involved in Preservative Freedom, please contact the secretariat at secretariat@preservativefreedom.com.
The Preservative Freedom campaign is led by a Coalition of leaders in eye health and care in the United States. The founding members of the coalition include Dry Eye University, The Glaucoma Foundation, Intrepid Eye Society, the National Medical Association of Ophthalmology Section, Real World Ophthalmology, and Thea Pharma Inc. Together, the group focuses on raising awareness of unmet needs in ocular surface disease and opportunities to pursue preservative-free topical ophthalmic medications.
Reference List
Newman-Casey, P. A., et al. (2023). The Support, Educate, Empower personalized glaucoma coaching trial design. Clinical trials (London, England), 20(2), 192–200.
PRC-EN-2271-v1 01.2025