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Hi All,
Saw this and hope it is useful to everyone when choosing Artificial tears.
Of course please seek professional advices.
http://www.agingeye.net/dryeyes/drye...gtreatment.php
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Which Artificial Tears should you use?
We list below guidelines that may be helpful in treating dry eyes. The guidelines listed below are derived from a review of the published literature.
● In dry eyes tear osmolarity increases. The tear hyperomolarity has been shown to cause ocular surface disease. Moderately hypotonic artificial tears has been shown to promote ocular surface disease healing in severe dry eyes. Available hypotonic tears include: Thera Tears, Hypotears and Akwa Tears. (Br J Ophthalmol. 2002 Aug;86(8):879-84, Ophthalmologica. 2001 Mar-Apr;215(2):124-7)
● Bicarbonate containing artificial tears have been shown to promote healing in severe dry eyes. Available bicarbonate containing tears include: Bion Tears, Murine Tears. (Arch Ophthalmol. 1995 Mar;113(3):371-8, Cornea. 1993 Mar;12(2):115-20)
● Prolonging the contact time of artificial tears on the cornea helps. This can be achieved using a gelling agent such as HP-guar (Systane), or using a viscous eye drop (Celluvisc/Liquigel).(Curr Med Res Opin. 2005 Feb;21(2):255-60, Curr Eye Res. 2004 Jan;28(1):55-62)
● Non preserved drops are the best. However if preserved eyedrops are to be used, then newer preservatives like GenAqua (Genteal Tears) are preferable to Benzalkonium chloride (BAC). When eyedrops containing Benzalkonium chloride (BAC) preservative are used frequently, some patients develop a condition called 'medicamentosa'. This condition mimics a severely irritated dry eye. The treatment is to stop the eyedrop and switching to non-preserved eyedrops.
● Oil containing eyedrops (Refresh Endura, Soothe) may be added if meibomian gland dysfunction is present. These eyedrops will replenish the lipid layer of the tear film and prevent tear evaporation. Warm compresses over closed eyelids for 5 minutes will also replenish the lipid layer.
● In severe dry eyes and unresponsive surface disease patients have significant visual impairment and disability. In such patients the use of autologus serum eye drops has been shown to help. . Natural human tears contain many growth factors, antibodies etc. Since these growth factors are present in serum, using serum eyedrops may provide the surface healing properties of natural tears. The major disadvantage of serum treatment is the requirement for blood donation. The active components of serum are stable for up to 6 months therefore bleeding and serum preparation are required two to three times a year. A standard method to prepare the serum eyedrops has been described. Blood banks may help you in preparing serum eyedrops.(Br J Ophthalmol. 2004 May;88(5):647-52, Graefes Arch Clin Exp Ophthalmol. 2005 Mar 9)
It is apparent that there is no single artificial tear eyedrop that provides all of the surface healing strategies (bicarbonate ions, hypotonicity, viscosity, non-preserved). Therefore perhaps it may be beneficial to try different artificial tears. In our opinion, OPTIVE or SYSTANE ULTRA are reasonable first choice for mild to moderate dry eyes and BLINK TEARS are reasonable first choice for severe dry eye with extensive surface disease. If there is significant eyelid disease (Blepharitis or MGD), then in addition to the above recommended artificial tears, one should use an oil containing artificial tear, either REFRESH ENDURA or SOOTHE XP. At night use a non-preserved ointment like Refresh PM ointment. Avoid Lacrilube as it has preservative (chlorbutanol).
● Avoid the use of redness relieving eyedrops (naphazoline or tetrahydrozoline eyedrops) such as Clear Eyes, Murine Plus and Visine and herbals such as witch hazel. Also avoid using Vaseline in the eye. Avoid aggressive washing of the eye with running water or saline. If there are mucous strands in the tear film, avoid using your fingers or tissue paper to sweep them out towards the nose by directly touching the eye surface. This may lead to "Mucous Fishing Syndrome" - a condition wherein the eye is red, irritated and sore because of constant trauma to the eye surface by patient's finger or tissue paper.
Saw this and hope it is useful to everyone when choosing Artificial tears.
Of course please seek professional advices.
http://www.agingeye.net/dryeyes/drye...gtreatment.php
------------------------------------------------------------
Which Artificial Tears should you use?
We list below guidelines that may be helpful in treating dry eyes. The guidelines listed below are derived from a review of the published literature.
● In dry eyes tear osmolarity increases. The tear hyperomolarity has been shown to cause ocular surface disease. Moderately hypotonic artificial tears has been shown to promote ocular surface disease healing in severe dry eyes. Available hypotonic tears include: Thera Tears, Hypotears and Akwa Tears. (Br J Ophthalmol. 2002 Aug;86(8):879-84, Ophthalmologica. 2001 Mar-Apr;215(2):124-7)
● Bicarbonate containing artificial tears have been shown to promote healing in severe dry eyes. Available bicarbonate containing tears include: Bion Tears, Murine Tears. (Arch Ophthalmol. 1995 Mar;113(3):371-8, Cornea. 1993 Mar;12(2):115-20)
● Prolonging the contact time of artificial tears on the cornea helps. This can be achieved using a gelling agent such as HP-guar (Systane), or using a viscous eye drop (Celluvisc/Liquigel).(Curr Med Res Opin. 2005 Feb;21(2):255-60, Curr Eye Res. 2004 Jan;28(1):55-62)
● Non preserved drops are the best. However if preserved eyedrops are to be used, then newer preservatives like GenAqua (Genteal Tears) are preferable to Benzalkonium chloride (BAC). When eyedrops containing Benzalkonium chloride (BAC) preservative are used frequently, some patients develop a condition called 'medicamentosa'. This condition mimics a severely irritated dry eye. The treatment is to stop the eyedrop and switching to non-preserved eyedrops.
● Oil containing eyedrops (Refresh Endura, Soothe) may be added if meibomian gland dysfunction is present. These eyedrops will replenish the lipid layer of the tear film and prevent tear evaporation. Warm compresses over closed eyelids for 5 minutes will also replenish the lipid layer.
● In severe dry eyes and unresponsive surface disease patients have significant visual impairment and disability. In such patients the use of autologus serum eye drops has been shown to help. . Natural human tears contain many growth factors, antibodies etc. Since these growth factors are present in serum, using serum eyedrops may provide the surface healing properties of natural tears. The major disadvantage of serum treatment is the requirement for blood donation. The active components of serum are stable for up to 6 months therefore bleeding and serum preparation are required two to three times a year. A standard method to prepare the serum eyedrops has been described. Blood banks may help you in preparing serum eyedrops.(Br J Ophthalmol. 2004 May;88(5):647-52, Graefes Arch Clin Exp Ophthalmol. 2005 Mar 9)
It is apparent that there is no single artificial tear eyedrop that provides all of the surface healing strategies (bicarbonate ions, hypotonicity, viscosity, non-preserved). Therefore perhaps it may be beneficial to try different artificial tears. In our opinion, OPTIVE or SYSTANE ULTRA are reasonable first choice for mild to moderate dry eyes and BLINK TEARS are reasonable first choice for severe dry eye with extensive surface disease. If there is significant eyelid disease (Blepharitis or MGD), then in addition to the above recommended artificial tears, one should use an oil containing artificial tear, either REFRESH ENDURA or SOOTHE XP. At night use a non-preserved ointment like Refresh PM ointment. Avoid Lacrilube as it has preservative (chlorbutanol).
● Avoid the use of redness relieving eyedrops (naphazoline or tetrahydrozoline eyedrops) such as Clear Eyes, Murine Plus and Visine and herbals such as witch hazel. Also avoid using Vaseline in the eye. Avoid aggressive washing of the eye with running water or saline. If there are mucous strands in the tear film, avoid using your fingers or tissue paper to sweep them out towards the nose by directly touching the eye surface. This may lead to "Mucous Fishing Syndrome" - a condition wherein the eye is red, irritated and sore because of constant trauma to the eye surface by patient's finger or tissue paper.
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