Your Patients Are Worried About BSS Availability — Here's How to Help

When patients hear that a critical surgical supply might be in short supply, anxiety is understandable. BSS Ophthalmic Solution (Balanced Salt Solution) is essential for the eye surgeries your patients depend on, and as a provider, you're in the best position to manage both the supply challenge and your patients' concerns.

This guide offers practical, actionable steps for ophthalmologists, ophthalmic surgeons, ASC administrators, and practice managers dealing with BSS supply constraints in 2026.

Current Availability of BSS Ophthalmic Solution

BSS Ophthalmic Solution is manufactured primarily by Alcon Laboratories and is available in 15 mL and 30 mL DROP-TAINER bottles. The enriched version, BSS Plus, comes in 250 mL and 500 mL glass containers.

Current market conditions:

• Alcon is the dominant FDA-approved manufacturer
• No formal FDA shortage listing as of Q1 2026
• Intermittent supply tightness reported by high-volume surgical centers
• Pricing ranges from $21-$42 per 15 mL vial (BSS) to ~$107 per 500 mL (BSS Plus)

For real-time stock data, check Medfinder for Providers.

Why Patients Can't Find BSS

It's worth understanding why BSS supply has tightened, so you can explain the situation to concerned patients:

1. Regulatory consolidation: FDA enforcement actions in 2008-2009 removed unapproved BSS manufacturers from the market, leaving Alcon as the primary supplier.
2. Manufacturer exits: Baxter discontinued its BSS product, further reducing supply sources.
3. Single-manufacturer dependency: With Alcon dominating the market, any production disruption cascades through the entire supply chain.
4. Growing demand: The aging U.S. population drives increasing volumes of cataract surgery and other ophthalmic procedures that require BSS.

For a patient-facing explanation you can share, see: Why Is BSS Ophthalmic Solution So Hard to Find?

What Providers Can Do: 5 Actionable Steps

Step 1: Diversify Your Supply Chain

The single biggest risk factor for BSS stockouts is relying on a single distributor. Build relationships with at least two to three distribution channels:

• Primary distributor (e.g., McKesson, Cardinal Health)
• Secondary specialty distributor focused on ophthalmic products
• Direct Alcon account for emergency orders

Specialty ophthalmic distributors sometimes receive allocation priority for BSS and related products. Don't overlook them.

Step 2: Maintain a Multi-Product Formulary

Don't stock only standard BSS. Maintain inventory of at least two irrigating solutions:

• BSS (Alcon) — standard irrigating solution for procedures under 60 minutes
• BSS Plus (Alcon) — enriched solution for longer or more complex procedures
• Navstel or Endosol Extra — backup options from non-Alcon manufacturers

Having alternatives already on your formulary means you can pivot immediately when one product becomes unavailable.

Step 3: Implement Inventory Monitoring

Set minimum stock thresholds for BSS based on your surgical volume. A practice performing 20 cataract surgeries per week needs a different buffer than one performing 5. Establish:

• Minimum stock levels (e.g., 2-week supply buffer)
• Automatic reorder triggers when inventory drops below threshold
• Weekly inventory audits during known supply constraint periods

Step 4: Use Real-Time Availability Tools

Medfinder for Providers offers real-time tracking of BSS availability across multiple suppliers. This eliminates the time-consuming process of calling distributors individually and helps you identify alternate sources quickly when your primary supplier is out of stock.

Step 5: Communicate Proactively With Patients

Patients who hear about shortages through news or social media may arrive at your office already anxious. Proactive communication helps:

• Reassure patients that your practice monitors BSS supply and maintains backup options
• Explain that multiple FDA-approved irrigating solutions exist and all provide safe surgical conditions
• Provide advance notice if a scheduling adjustment becomes necessary
• Share patient-facing resources like this shortage update article

Alternatives to Recommend

When standard BSS is unavailable, guide patients and staff toward these options:

• BSS Plus: Best for longer procedures. Contains bicarbonate, dextrose, and glutathione for enhanced corneal protection. ~$107 per 500 mL.
• Navstel: Balanced salt solution with hypromellose, dextrose, and glutathione. FDA-approved for intraocular use.
• Endosol Extra: Alternative intraocular irrigating solution from a non-Alcon manufacturer.

For a comprehensive comparison to share with patients: Alternatives to BSS Ophthalmic Solution.

Workflow Tips for Managing BSS Supply

Integrate BSS supply management into your existing workflows:

• Pre-surgical checklist: Add BSS/irrigating solution verification to your surgical day prep checklist
• Weekly supply review: Designate a staff member to review BSS inventory and reorder status weekly
• Distributor communication: Establish a point of contact at each distributor who can provide supply forecasts
• Peer networking: Connect with nearby practices to share supply intelligence and, when appropriate, coordinate emergency loans of surgical supplies
• Documentation: Track BSS usage patterns to optimize ordering quantities and timing

Final Thoughts

BSS Ophthalmic Solution supply management has become a necessary operational competency for ophthalmic practices in 2026. The practices that handle it best are those that treat it as an ongoing logistics challenge rather than a one-time crisis.

By diversifying suppliers, maintaining formulary flexibility, leveraging tools like Medfinder for Providers, and communicating transparently with patients, you can ensure that BSS availability doesn't disrupt your surgical schedule or your patients' care.

For the provider-focused shortage briefing, see: BSS Ophthalmic Solution Shortage: What Providers and Prescribers Need to Know.