Artificial tears potpourri: a literature review

Abstract

Numerous brands and types of artificial tears are available on the market for the treatment of dysfunctional tear syndrome. Past literature has focused on comparing the components of these products on patient’s clinical improvement. The wide array of products on the market presents challenges to both clinicians and patients when trying to choose between available tear replacement therapies. Different formulations affect patients based on etiology and severity of disease. In order to provide an unbiased comparison between available tear replacement therapies, we conducted a literature review of existing studies and National Institutes of Health clinical trials on commercially available, brand name artificial tears. Outcomes evaluated in each study, as well as the percent of patients showing clinical and symptomatic improvement, were analyzed. Fifty-one studies evaluating different brands of artificial tears, and their efficacy were identified. Out of the 51 studies, 18 were comparison studies testing brand name artificial tears directly against each other. Nearly all formulations of artificial tears provided significant benefit to patients with dysfunctional tear syndrome, but some proved superior to others. From the study data, a recommended treatment flowchart was derived.

Over the counter (OTC) artificial tear drops for dry eye syndrome

“…Alves 2013, Calonge 2001, Doughty 2009, and Moshirfar 2014 have all produced reviews related to OTC artificial tears. None of these reviews limited their searches to RCTs, or produced and meta-analyzed results.…”

“…Doughty 2009 is a systematic review of studies that only used rose bengal staining to evaluate the efficacy of artificial tears. Moshirfar 2014 is a systematic review of currently-marketed artificial tears (all others were excluded); this review included short studies (e.g. 60 minutes), and commented on how artificial tear study outcomes were likely related to funding sources.…”

Dysfunctional tear syndrome

“…Clinical studies investigating the efficacy of various formulations of tear supplements have been conducted, including comparative studies to evaluate the differential effects on patient symptoms and clinical signs of DTS [92]. The use of preserved tear supplements is appropriate for many patients with mild tear deficiency to relieve the symptoms of DTS, as needed.…”

Comparative Proteomics of Mouse Tears and Saliva: Evidence from Large Protein Families for Functional Adaptation

“…The lacrimal glands are the major sources of proteins in tears, although this fluid also contains water, glucose, salts and lipids secreted by a variety of sources [4,5,6]. While these components are common to the eyes of most or all mammals, other components, especially proteins, may be present in tears of some mammals but not others because they confer functions that are adaptive to the ecological niche of those possessing them [7].…”