Dry eye: why artificial tears are not always the answer

Abstract

Dry eye disease (DED) is a multifactorial disease that manifests in patients with a variety of symptoms and signs such as ocular pain, visual issues, rapid tear evaporation and/or decreased tear production. It is a global health problem and is the leading cause of optometry and ophthalmology clinic visits. The mainstay therapy for DED is artificial tears (ATs), which mimics tears and improves tear stability and properties. ATs have been found to improve symptoms and signs of disease in all DED subtypes, including aqueous deficient DED and evaporative DED. However, given the heterogeneity of DED, it is not surprising that ATs are not effective in all patients. When AT fails to relieve symptoms and/or signs of DED, it is critical to identify the underlying contributors to disease and escalate therapy appropriately. This includes underlying systemic diseases, meibomian gland dysfunction, anatomical abnormalities and neuropathic dysfunction. Thus, this review will discuss the benefits and limitations of ATs and review conditions when escalation of therapy should be considered in DED.

Current Advances in Mechanisms and Treatment of Dry Eye Disease: Toward Anti-inflammatory and Immunomodulatory Therapy and Traditional Chinese Medicine

“…However, various methods can only reduce but not completely eliminate the symptoms of DED. Artificial tears ( 87 ), silicone eye shields ( 88 ), gas lenses ( 89 ) and corneal contact lenses ( 90 ) are the basic treatment for DED, but in moderate-to-severe DED with ocular surface inflammation, anti-inflammatory and immunosuppressive treatments are essential ( Table 2 ) ( 128 ).…”

Varenicline Solution Nasal Spray: A Review in Dry Eye Disease

“…Normal tear film consists of aqueous fluid, electrolytes and an array of mucin glycoproteins, lipids and proteins (including trophic/wound healing, innate defence/antimicrobial and anti-inflammatory/antioxidant factors) that enable it to perform its basic functions of lubricating and protecting the ocular surface [ 30 ]. As such, there is an important distinction between intranasally administered varenicline solution and topically applied artificial tears in terms of how these differing treatment modalities fundamentally address DED symptoms: the former is designed to increase the secretion of endogenous tears (with all of their lubricant and protective properties), whereas the latter are intended to mimic the secretion of natural tears without replicating their complex composition (and hence all of their various functions) [ 31 , 32 ]. Moreover, efficacy findings for varenicline solution compare favourably with those for topical anti-inflammatory drugs (cyclosporine and lifitegrast) in terms of the speed of onset and/or extent of increase in natural tear production, albeit based on indirect comparisons that are inherently limited in nature [ 27 , 33 , 34 ].…”

Распространенность Цифрового Напряжения Глаз Украинских Студентов И Возможности Его Снижения

“…В нашей выборке 64,1% (205/320) студентов имели симптомы, связанные с синдромом сухого глаза. Уменьшение частоты моргания и неполное моргание при работе с цифровыми устройствами ассоциируются с усилением симптомов напряжения глаз [8], усиленным испарением водного слоя слезной пленки и сухостью [40].…”