Artificial tears keratitis

The development of latanoprost-induced corneal dendritiform epitheliopathy has been reported. These lesions resemble those of herpes simplex virus epithelial keratitis, but, in contrast to herpes simplex virus disease, the pseudodendrites associated with latanoprost promptly disappear on discontinuation of drug therapy. Coincident with discontinuation of latanoprost, patients can be treated with preservative-free artificial tears with or without topical antibiotics. 

Polymer-based artificial tears are the most common tear supplementation product used in dry eye treatment. In addition to dry eye, ocular lubricants are used in the treatment of corneal abrasions, ultraviolet keratitis, herpes simplex and zoster keratitis, phlyctenular disease, giant papillary conjunctivitis, superior limbic keratoconjimc-tivitis, vernal disease, adenoviral infections, and other ocular surfece conditions. 

WerblinTF Rheinstrom SD, Kaufman HE.The use of slow-release artificial tears in the long-term management of keratitis sicca. Ophthalmology 1981 88 78-81. 

Mucous plaque keratitis can be treated with 10% acetylcysteine but also resolves without treatment. Keeping the eye moist with artificial tears may be helpful. Exposiue keratitis and neruotropic keratitis are best treated with artificial tears, lid taping at bedtime, and, if necessary, tarsorrhaphy. Therapeutic contact lenses should not be used because of the risk of developing infectious ulcers in an eye with decreased sensitivity. 

Dry eye symptoms and significant ocular surface disease frequently occur in patients taking isotretinoin.The associated symptoms may be accompanied by blepharocon-jimctivitis. The presence of isotretinoin in tear fluid decreases stability (and tear break-up time) of the lipid layer of the tear film but may also cause a decrease in aqueous production, leading to ocular surface dryness. These effects could be responsible for the dry eye symptoms, contact lens intolerance, superficial punctate keratitis, and conjunctival irritation accompanying isotretinoin therapy. Use of artificial tear preparations may help to alleviate the associated discomfort. 

A 49-year-old woman developed repeated episodes of severe keratitis after radial keratotomy for myopia (329). After 18 months of repeated hospital admissions, several operations, and considerably reduced visual acuity, it eventually transpired that she had been self-medicating with 1 % proparacaine mixed with artificial tears to control pain after her surgery. 

Hydroxypropyl cellulose (HPC) is used for the preparation of artificial tears, treat medical conditions characterized by insufficient tear production such as kerotoconjunctivitis sicca, recurrent corneal erosions, decreased corneal sensitivity, exposure, and neuroparalytic keratitis. It is also used as a disintegrant and a binder in tablets, sieving matrix for DNA separations by capillary and microchip electrophoresis and lubricant for artificial eyes, food additive, thickener, and as an emulsion stabilizer [111, 112]. 

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