Since the onset of the COVID-19 pandemic, there has been an advisory for regular 
and thorough cleaning of hands besides other measures such as social distancing 
and self-isolation. The rationale for the same is to prevent the transfer of the 
virus from hands that have come in contact with fomites. While both 
alcohol-based hand rubs (ABHR) or washing with soap and water are claimed to 
have been effective, hand sanitizers have gained more popularity due to the ease 
of use. The increased frequency of ABHR use and the aerosols generated pose a 
potential threat to the skin and exposed mucosal surfaces, especially that of 
the eye due to the proximity of use. The adverse effects of alcohol in these 
sanitizers can be manifold. An allergic or inflammatory response can occur 
depending on the predisposing or preexisting conditions. This article describes 
the risks, underlying mechanisms, and preventive measures for sanitizer 
aerosol-driven ocular surface disease.