Artificial tears

A subset of various brands of artificial tears displayed in a store

Artificial tears are lubricant eye drops used to treat the dryness and irritation associated with deficient tear production in keratoconjunctivitis sicca (dry eyes).[1] They are also used to moisten contact lenses and in eye examinations.

Artificial tears are available over-the-counter. Artificial tears are supplemented with other treatments in moderate to severe forms of dry eyes.

Chemistry

Preparations contain carboxymethyl cellulose,[2] polyvinyl alcohol,[2] hydroxypropyl methylcellulose[2] (a.k.a. HPMC or hypromellose), hydroxypropyl cellulose[1] and hyaluronic acid (a.k.a. hyaluronan, HA)[3] They contain water, salts and polymers but lack the proteins found in natural tears. Patients who use them more frequently than once every three hours[1] should choose a brand without preservatives[1] or one with non-irritating preservatives.

Effects

Application of artificial tears every few hours[4] can provide temporary relief from the symptoms of dry eyes. Hydroxypropyl cellulose stabilizes and thickens the precorneal tear film and prolongs the tear film breakup time.[1]

Usage

Artificial tears usually are the first line of treatment for dry eyes.[5] While mild cases require application of lubricant drops four times a day, severe cases require more aggressive treatment, such as ten to twelve times a day.[1] Thicker artificial tears can be used in severe cases, although these may temporarily blur vision.[1]

Precautions

Drops for red eyes can make the eyes drier.[5] If wearing contact lenses, rewetting or lubricating drops specifically for contact lenses should be used.[5] Other types of drops may contain ingredients that damage contact lenses.[5]

Adverse effects, interactions and contraindications

Possible adverse effects of carboxymethyl cellulose and similar lubricants include eye pain, irritation, continued redness, and vision changes.[1] Use should be discontinued if any of them occur.[1] Side effects of hydroxypropyl cellulose include hyperaemia, photophobia, stickiness of eyelashes, discomfort, and irritation.[1] However, the overall side-effect profile of artificial tears is very low.[2]

Artificial tears have no reported interactions.[1] A documented contraindication of artificial tears is hypersensitivity.[1]

Veterinary uses

Artificial tears are a part of the topical therapy for keratoconjunctivitis sicca for animals such as dogs, cats and horses.[6]

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 "Keratoconjunctivitis, Sicca". eMedicine. WebMD, Inc. 2006-04-21. Archived from the original on 16 October 2006. Retrieved 2006-11-12.
  2. 1 2 3 4 Moshirfar M, Pierson K, Hanamaikai K, Santiago-Caban L, Muthappan V, Passi SF (July 2014). "Artificial tears potpourri: a literature review". Clin Ophthalmol 31 (8): 1419–33. doi:10.2147/OPTH.S65263. PMC 4124072. PMID 25114502.
  3. ↑ Troiano, P; Monaco G (27 December 2008). "Effect of hypotonic 0.4% hyaluronic acid drops in dry eye patients: a cross-over study.". Cornea 10 (10): 1126–30. doi:10.1097/ICO.0b013e318180e55c. PMID 19034126.
  4. ↑ "Keratoconjunctivitis Sicca". The Merck Manual, Home Health Handbook. Merck & Co., Inc. 2003-02-01. Retrieved 2006-11-12.
  5. 1 2 3 4 Meadows, Michelle (May–June 2005). "Dealing with Dry Eye". FDA Consumer Magazine. U.S. Food and Drug Administration. Retrieved 2011-11-22. External link in |work= (help)
  6. ↑ "Keratoconjunctivitis, Sicca". The Merck Veterinary Manual. Merck & Co., Inc. Retrieved 2006-11-18.

External links

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