Eye drops that increase mucin production?

[Matt0029]

I read something online about what they called second generation eye drops that help your eyes product more mucins. Are any drops that do this available yet. Or is this speculation for the future?

[Milo007]

Not really. Eye drops that stimulate the growth of goblet cells and thereby mucin are called "mucin secretagogues". They have been available for quite a while now and I have used one in the past which had the drug "rebamipide" as the active ingredient. They are supposed to restore the goblet cell density which might be reduced due to chemical or thermal injuries. The mucin and micro villi layer is the innermost layer of the tear film that adheres the aqueous component of the tear film to the conjunctiva. So mucin secretagogues would work well for those who have goblet cell deficiency and decreased mucin production. They are not supposed to improve symptoms of lipid deficient or aqueous deficient dry eyes.

[Matt0029]

That you! Are these prescription drops then?

[Milo007]

That you! Are these prescription drops then?

Yes of course!

[Matt0029]

Thanks. Did they work for you? Are the safe? or are they like steriods with a poor safety profile?

[Milo007]

Thanks. Did they work for you? Are the safe? or are they like steriods with a poor safety profile?

They didn't work for me as I have lipid deficient dry eyes. They are not supposed to help with aqueous deficienct dry eye as well. If you don't have goblet cell deficiency then these drugs are of no use to you. They are meant for limited period use and are generally safe for that finite period of use (apart from the damage to ocular tissues by the preservatives in the drops).

[Matt0029]

Thank you. Is there any way an eye doc. Can tell if your mucin deficient? I know on steriods my tbut goes right up. From 4 to 8 to 10seconds. So kinda wondering if it's a lack of mucin causing my low tbut. As steriods are supposed to improve mucin production? I think.

[Milo007]

Thank you. Is there any way an eye doc. Can tell if your mucin deficient? I know on steriods my tbut goes right up. From 4 to 8 to 10seconds. So kinda wondering if it's a lack of mucin causing my low tbut. As steriods are supposed to improve mucin production? I think.

If steroids are causing your TBUT to go high then your issue is inflammation. Inflammation causes the meibomian and lacrimal glands to under perform over time and over very long time they can damage them permanently. Steroids are not known to cause an increase in mucin production. So if steroids are helping inflammation is your issue. Now the question is what's causing the inflammation?

This is what your doctor has to find out!

[Matt0029]

Thanks that has given me alot of information to build on. I guess it really hard to find out?

[Milo007]

Thanks that has given me alot of information to build on. I guess it really hard to find out?

I can list some of the common sources of inflammation. But it's really difficult to get things self diagnosed. Let's try to guess what's wrong in your case.

Do you use moisture chamber glasses?

[Matt0029]

Thanks that would help. No I don't. I am going to buy some moisture chamber/realease glasses for an airplane trip coming up soon. I really struggle on planes.

[Milo007]

Thanks that would help. No I don't. I am going to buy some moisture chamber/realease glasses for an airplane trip coming up soon. I really struggle on planes.

The most profound source of inflammation is due to rapid evaporation of tears resulting in tear hyperosmolarity. If moisture chamber glasses do make you comfortable you will come to know about it. Let's wait until you get hold of your MCGs.

[Matt0029]

Thank you it does sound quiet likely this could be my cause. Low tbut. Can this be treated successfully without steroids? Would be amazing to have the level of eye comfort and vision I have when on steriod drops, all the time. Was fully cured after a long course of steroids but it sadly all came back.

[Milo007]

Can this be treated successfully without steroids? Would be amazing to have the level of eye comfort and vision I have when on steriod drops, all the time. Was fully cured after a long course of steroids but it sadly all came back.

I think it's very dangerous to use steroids as the primary mode of treatment on a long term basis. Will they help increase your TBUT and normalize things?

Certainly yes if inflammation is causing your glands to malfunction. You said it yourself that a long course of steroids almost cured your condition! So congratulations you have a lot of hope. If steroids are making things normal that indicates your glands haven't lost the ability to secrete and addressing the causes of inflammation will "cure" your condition which is an unimaginable feat for a dry eye sufferer. But steroids are not an answer forever. You need to eliminate the sources of inflammation. It's that simple.

Things reverting back to the abnormal conditions suggests that the source of inflammation still persists. Steroids only bailed you out of the situation on a temporary basis.

[Matt0029]

Is finding the source almost impossible though? I will look forward to my next week doc. Appointment to discuss all this. You sound very knowledgeable thanks for all the information.