Dry Eye Drops

There are many Dry Eye medications on the market, especially different forms of eye drops and ointments. Restasis is the only FDA approved eye drop for DED (dry eye disease) which been proven to work in chronic inflammatory dry eyes.

There are many different products available over-the-counter, or on prescription only. Although most artificial tears contain similar ingredients, they differ in the type of lubricant used, in their chemical properties & in the type (or lack thereof) of preservatives used. These are broadly classed under

dry-eye-treatment

HMC-Based Artificial Tears

HMC-based artificial tears work on the simple principle of lubricating the ocular surface in order to promote the integrity of the surface, but do not have viscosity-increasing properties.

Several brands of artificial tears:

Tears Naturale /Genteal (Alcon), contains hypromellose and a gentle preservative (polyquad in tears naturale).

Hypromellose (multiple pharma companies) contains hypromellose & generally the preservative is Benzylkonium chloride, which can destabilize the tear film.

Artelac (Bausch & Lomb) 0.32 % hypromellose.

Bion Tears (Alcon), contain hypromellose, dextran, zinc & bicarbonate and are only available on prescription. They are more beneficial in relieving dryness and irritation caused by Sjogrens.

Ilube (Moorfields Pharmaceuticals) contains 5 % acetylcysteine & hypromellose, both these ingredients work together for DED due to abnormal mucus production.

Tear-Lac (Scope Ophthalmics) contains 0.3 % hypromellose preservative free.

 

CMC-Based Artificial Tears

Carboxy methylcellulose (CMC) is a polysaccharide known as mucilage. They increase the residence time of tears as well as increase the viscosity of tears.

Commonly available CMC artificial tears include

Optive / Celluvisc / Refresh (Allergan)  – contain CMC & provide osmoprotection against high osmolarity of the tear film in DED.

TheraTears (Advanced Vision Research) eye drops and liquid gel contain carboxymethycellulose and provide a tear matched electrolyte balanced solution for dry eyes. 

 

Propylene Glycol Based Artificial Tears

Systane / Systane Ultra (Alcon) contains polyethylene glycol & HP guar. The HP guar in this artificial tear brand is gel-forming and offers unique properties that improve recovery of the ocular surface due to possible increased retention of the artificial tear drop, and increase in tear film break up time.

Systane Balance (Alcon) may be helpful in patients with conditions causing evaporative dry eye (e.g., meibomian gland disease).

Blink Tears (Abbott Medical Optics). Its contains polyethylene glycol, Hyaluronate  with “ocupure” preservative and is clinically shown to improve tear film stability

 

SH-Based Artificial Tears

Recent studies have shown that Sodium hyaluronate eye drops are useful in improving subjective symptoms (as well as the ocular health) of dry eye patients, treating lipid tear-deficient patients and managing Sjogrens syndrome patients. Sodium hyaluronate also seems to have protective effects on the corneal epithelium and may be useful in a wide variety of patients with dry eye.

Hylo-tears/ Hylo- forte (Scope Ophthalmics): preservative free 0.1 % /0.2 % Hyaluronate.

Artelac Rebalance (Bausch & Lomb) contains 0.15 % hyaluronate, Vit B12, mineral nutrients & an innovative preservative Oxyd.

Clinitas soothe (Altacor) 0.4% hyaluronate preservative free.

Lubristil (Moorfields Pharmaceuticals)?contains 0.15% hyaluronate preservative free.

 

PVA-Based Artificial Tears

Polyvinyl alcohol lubricates the ocular surface.

Clinitas Ultra (Altocor) contains PVA & povidone with a mild preservative

Murine Tears (Murine Eye Care), contains PVAl, povidone & six of the 11 major ingredients found in natural tears.

 

Oil-Based Tears

Castor/Soya bean oil aids in the reformation of the lipid layer of the tear film and prevents evaporation of the existing tear film. Oil-based eye drops are used in the treatment of meibomian gland disease.

Optive Plus (Allergan) contains castor oil

Emustil (Moorfields Pharmaceutical) is made from 7% Soybean oil and 3% Natural Phospholipids

 

Anti-Inflammatory Drops

Restasis (Allergan) – This is the only FDA approved medication for Dry Eye Syndrome. Recommended doses are 1 drop twice a day. It’s important to note that this medicine is not intended for instant relief, but rather a long-term medication that doesn’t have the side effects of steroid-based eye drops.

 

Steroid-Based Drops

It’s important to know that long-term use of steroid eye drops can cause a rise in eye pressure and development of a cataract. None of the eye drops listed below should be taken without the consent of your eye care professional. They are Alrex, Lotemax, FML and Vexol.