How Hypochlorous Acid is Changing Eye Infection Treatment

As an adjunctive therapy for treating eye infections, hypochlorous acid (HOCl) solutions are gaining attention in the eye care community for the beneficial properties of the HOCl molecule when topically applied to the eye.

In this article, we review the ocular health applications of hypochlorous, highlighting its potent antimicrobial action and clinical efficacy in conditions such as conjunctivitis, arguably making it a revolutionary alternative treatment option for ocular and peri-ocular infections.


As a patient, if you know, you know: Stubborn eye infections and other bacterial-related ocular conditions can pose daily challenges.

While various antibacterial agents offer benefits in targeting acute symptoms, hypochlorous acid (HOCl) emerges as a promising adjuvant topical therapy for clinicians aiming to treat and prevent conditions such as conjunctivitis⁵⁻⁷. With its potent antimicrobial properties, HOCl continues to be a game-changer in specialized eye care.

To help prove out exactly why this is the case, let’s dive into some of the clinical literature on HOCl in the prevention and treatment of eye infections and discuss an HOCl solution worth considering.

Optometrist looking into patient's eyes

What is an eye infection and how does it happen?

Eye infections are caused by the invasion of harmful microorganisms—bacteria, viruses, fungi, or parasites—into the eye or its surrounding structures¹. These infections can affect various parts of the eye, including the conjunctiva (conjunctivitis), cornea (keratitis), eyelid (blepharitis), and the interior structures (endophthalmitis)¹. Conjunctivitis, commonly known as "pink eye," is one of the most prevalent eye infections, characterized by inflammation of the conjunctiva, the thin, transparent layer covering the white part of the eye and the inner surface of the eyelids².

Infections occur when pathogens bypass the eye's natural defense mechanisms, such as the tear film, which contains antimicrobial proteins and immunoglobulins, and the physical barrier of the corneal epithelium¹⁻³. Factors like poor hygiene, contact lens use, trauma, or pre-existing ocular conditions can compromise these defences, facilitating microbial entry and proliferation¹⁻³. Once inside, these pathogens can trigger an inflammatory response, leading to symptoms such as redness, pain, discharge, and blurred vision¹⁻³. The immune response aims to eliminate the infection but can also cause tissue damage and exacerbate symptoms³. Understanding the etiology and pathophysiology of eye infections is crucial for developing effective treatments and preventive strategies¹⁻³.

Hypochlorous acid in a white bottle shown in a laboratory setting

What is hypochlorous acid (HOCl)?

Hypochlorous acid (HOCl) is a naturally occurring antimicrobial agent produced by the human immune system, specifically by neutrophils during the respiratory burst to combat pathogens⁴. Chemically, HOCl is a weak acid formed when chlorine dissolves in water. Its potent antimicrobial properties stem from its ability to disrupt the cell membranes and proteins of a wide range of microorganisms, including bacteria, viruses, and fungi, leading to their rapid inactivation and destruction⁴.

In ocular health, HOCl’s broad-spectrum antimicrobial action makes it highly effective against common pathogens responsible for conditions such as conjunctivitis and blepharitis⁵⁻⁷. The molecule is biocompatible and non-toxic to human cells, making it safe for use on the delicate tissues of the eye⁵⁻⁷. Its efficacy, combined with a low risk of irritation or side effects, positions HOCl as a valuable tool, complimenting existing therapies, in managing ocular infections, promoting healing, and maintaining overall eye health⁵⁻⁷.

A bottle of BIHOCL O.D. spray being held by a person
Photo credit: Eye Spa Komoka

BIHOCL O.D.: Hypochlorous-Based Eyegiene

Preventing eye infections starts with an effective ocular hygiene regime that removes bacterial and microbial factors that contribute to infection, inflammation, and irritation. Hypochlorous acid (or HOCl) based eye care solutions are efficacious, yet gentle, products that can be used daily to establish and maintain optimal ocular hygiene.

BIHOCL O.D. is Biomiq’s pure hypochlorous acid ocular hygiene product line for use and retail by eye care professionals. The product can be easily incorporated into daily hygiene as an effective lid and lash cleansing solution and it incorporates all of the beneficial properties of pure hypochlorous acid. Plus, it is non-toxic, safe for mucosal contact at all ages, and is manufactured with only two ingredients—purified water and medical grade salt.

What Clinical Literature Has to Say About HOCl

Bertone et al. (2022)

A 2022 study⁵ conducted by scholars Bertone et al. investigates the efficacy of hypochlorous acid (HOCl) in managing eye infections through a detailed case series analysis. In this case series, HOCl was administered to patients with various ocular infections, including bacterial, viral, and fungal etiologies⁵. The results demonstrated significant improvements in clinical outcomes, with marked reductions in signs and symptoms such as redness, swelling, and discharge⁵. The study highlights how HOCl can rapidly neutralize pathogens without causing irritation or adverse effects, suggesting that HOCl could serve as a valuable addition to the current therapeutic arsenal for ocular infections, particularly given its broad-spectrum antimicrobial activity and low propensity for inducing resistance⁵.

Adamson et al. (2015)

Similarly, a 2015 study⁶ by scholars Adamson et al., investigated the efficacy of ultrapure, stable HOCl in treating bacterial and viral conjunctivitis across 79 patient cases. The research showcased that HOCl significantly alleviated the symptoms of conjunctivitis, such as eye redness, irritation, and discharge, within a short treatment duration⁶. Patients experienced rapid symptom relief, with a notable reduction in infection markers, underscoring the antimicrobial potency of HOCl against both bacterial and viral pathogens⁶. The study further highlights the safety profile of HOCl, as no adverse effects were reported throughout the treatment period⁶.

Stroman, D. W. et al. (2017)

Lastly, a 2017 study⁷ by Stroman, D. W. et al., investigated the the impact of a hypochlorous acid (HOCl) on reducing bacterial load on ocular skin. The study demonstrated that applying HOCl significantly decreased the presence of bacteria on the periocular area, effectively lowering the risk of bacterial infections by 99.6% without compromising the delicate skin microbiome in the periocular area⁷. The results underscored HOCl’s potent antimicrobial properties, and further confirmed the safety and tolerability of HOCl, as no adverse reactions were observed during the use of the hygiene solution⁷. These findings highlight HOCl's potential as a preventative measure in ocular hygiene, offering a robust and safe method to reduce bacterial contamination around the eyes⁷.

Final Thoughts

The emerging body of research highlights the significant role of hypochlorous acid in ocular health, particularly in the management and prevention of eye infections⁴⁻⁷. Existing studies⁵⁻⁷ provide compelling evidence of HOCl’s efficacy in treating bacterial, viral, and fungal conjunctivitis, demonstrating rapid symptom relief and significant reductions in bacterial markers without adverse effects. Additionally, research underscores the importance of HOCl in reducing bacterial load on the ocular skin, showcasing its potential as a preventative hygiene solution⁷. These findings collectively underscore HOCl’s broad-spectrum antimicrobial activity and its safety profile, making it a valuable adjunctive therapy in ocular infection management⁵⁻⁷.

Incorporating HOCl into ocular health practices offers a dual advantage: effectively managing active infections and serving as a preventative measure to reduce the risk of future infections⁵⁻⁷. Its ability to neutralize pathogens swiftly without promoting resistance or causing irritation positions HOCl as a promising complement to traditional treatments⁵⁻⁷.

As research continues to validate its benefits and optimize its application protocols, HOCl stands out as a promising solution to enhance patient outcomes and improve overall ocular hygiene⁵⁻⁷. This underscores the growing recognition of HOCl’s critical role in advancing ocular health and infection management.

To learn more about BIHOCL O.D., explore our Eye Care page or view the product.



  1. Clare, G., Kempen, J. H., & Pavésio, C. (2024). Infectious eye disease in the 21st century—an overview. Eye, 1-14.
  2. Lindquist, T. D., & Lindquist, T. P. (2021). Conjunctivitis: an overview and classification. Cornea, E-Book, 358.
  3. Lynn, W. A., & Lightman, S. (2004). The eye in systemic infection. The Lancet, 364(9443), 1439-1450.
  4. Block, M. S., & Rowan, B. G. (2020). Hypochlorous acid: a review. Journal of Oral and Maxillofacial Surgery, 78(9), 1461-1466.
  5. Bertone, C., Mollicone, A., Russo, S., Sasso, P., Fasciani, R., Riccardi, C., ... & ALI working group. (2022). The role of hypochlorous acid in the management of eye infections: a case series. Drugs in Context, 11.
  6. Adamson, P. S., Roos, H., & von Holdt, J. (2015). Treatment of bacterial and viral conjunctivitis with topical ultrapure stable hypochlorous acid (HOCl): a clinical evaluation and treatment response in 79 cases. Investigative Ophthalmology & Visual Science, 56(7), 280-280.
  7. Stroman, D. W., Mintun, K., Epstein, A. B., Brimer, C. M., Patel, C. R., Branch, J. D., & Najafi-Tagol, K. (2017). Reduction in bacterial load using hypochlorous acid hygiene solution on ocular skin. Clinical Ophthalmology, 707-714.

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