Tear supplementation Artificial tears

Tear supplementation artificial tears, Lacrisert Tear conservation ointment, punctal occlusion Tear stimulation secretogogues, anti-inflammatories/ immunomodulators... 

Applications artificial fiber (food supplement), artificial tears, food (emulsifier, thickener), glue, mortar, paper, pharmaceutical (controlled release, scaffolds, tablet coating, thickener) Shen, H Ma, Y Luo, Y Zhang, Z Dai, J, Colloids Surf. B Biointerfaces, 135, 332-8, 2015. 

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. 

The ideal artificial tear would reproduce the metabolic, optical, and physical characteristics of natmal tears. Additionally, it would have a long ocular residence time and would contain therapeutic additives to treat primary and secondary damage to the eye. Supplementation of natural tears with a substance that prolongs residence time generally improves tear film breakup time (TBUT) and is superior to tear replacement fluids of low retention time. 

The device is generally comfortable and well accepted by many patients, but its use does have certain disadvantages. Some patients have problems with discomfort (foreign body sensation) or expulsion of the Lacrisert.The insert can be wetted with saline before insertion to improve comfort, but this can make even more difficult the insert s placement into the lower cul-de-sac, which requires a moderate amount of dexterity. Supplementation with artificial tears after insertion may improve comfort. The most common patient complaint is blurred vision associated with the intense release of polymer during the first 4 to 6 hours after instillation, from a thickened tear film.Adding such fluid as drops of NaCl 0.9% or artificial tear solution can reduce the tear film viscosity and minimize the visual complaints. As the insert dissolves it releases debris that can blur vision and cause irritation. Most patients with mild signs and symptoms of dry eye do not experience improvement with use of the insert, as compared with the use of conventional tear solutions. Because some tear secretion is necessary to dissolve the Lacrisert, KCS patients with low basal tear secretion may not benefit from or tolerate its use. 

Tear supplements continue to be a rapidly evolving market.As many as 50 different over-the-counter artificial tears are available.These formulations are available either in unit-dose vials or in multidose bottle delivery systems and vary by consistency, active ingredients, and preservatives.Table 24-3 lists many of these preparations. 

Dry eye treatment with topical artificial tears hot compressesAid care routines, environment modification, immunomodulatory drugs and nutritional supplements. (Note that estrogen or androgen-based drops may be a promising new treatment.)... 

MethylceUulose has got a large number of applicatimis like thickeners and emulsifiers. It is also used in the treatment of constipation, as artificial tears and saliva and nutritional supplement capsules. It has got applications in constraction industry as glue and binders with wide range uses in textile and paper industries. 

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