Does the temperature of an artificial tear affect its comfort?

Abstract

There is no advantage, with respect to patient perceived comfort, in refrigerating the Systane Ultra (Alcon Laboratories) AT for mild to moderate DE.

A Decade of Effective Dry Eye Disease Management with Systane Ultra (Polyethylene Glycol/Propylene Glycol with Hydroxypropyl Guar) Lubricant Eye Drops

“…Following exposure to a validated simulated adverse environment model created by a 45 cm 55-W standing fan directed towards the eye, at a distance of 1m for 2.5 minutes, PEG/PG with HP guar increased NIBUT (P< 0.001) and prevented its decline below baseline. 47 While the manufacturer's recommendation is to store PEG/PG with HP guar at room temperature, Bitton et al 48 demonstrated that the effect of PEG/PG with HP guar in providing comfort is the same irrespective of storage temperature. Based on patient-reported outcomes, the study did not reveal any advantage in refrigerating the drops prior to use either in the morning or late in the day in mild-to-moderate DED patients.…”

Re: Does the temperature of an artificial tear affect its comfort?

“…That finding does not preclude the possibility that the range of responses to drop temperature might be wider for subjects with a spectrum of marginal tear dysfunction through to severe dry eye disease. 1 Initial drop comfort can be important because drops which irritate can create, increase and help maintain drop instillation apprehension and aversion, as well as stimulate reflex lacrimation. 2 Reflex lacrimation accelerates washout and dilutes the therapeutic potential of a drop.…”

“…Depending on drop characteristicssuch as pH, buffering capacity, osmolarity and viscositytemperature preference for storage temperature might vary for the same patient depending on which product they use. 1 Unfortunately, too often drops are supplied 'over the counter' in an advice vacuum. Patient training can improve drop placement skills with benefits to safety, comfort and therapeutic effect.…”

Response to Re: Does the temperature of an artificial tear affect its comfort?

“…EDITOR: I would like to thank Dr McMonnies for commenting on our article . His concerns about patient compliance with artificial tears (AT), or any drops for that matter, is something that we all share as practitioners.…”

“…Furthermore, manufacturers recommend the storage of AT at ‘room temperature’ or between ‘15–30°C’ (Table 1 of our paper), and not refrigerated (typically < 5°C). The results of our study showed no preference between ambient and refrigerated AT in mild to moderate DE participants.…”