Updated: Oct 5, 2020
One can get lost in the world of artificial tears because of the wide array of options to choose from. From stabilizing the tear film to changing the chemical composition of the tears to helping promote healing of cells on the surface of the eye, different artificial tears have different mechanisms of action.
Artificial tears are usually recommended as a first line of treatment for dry eye syndrome, which, especially here in Alberta, is a very common condition. Many people complain about burning, redness, foreign body sensation and fluctuating vision, which are all common symptoms of dry eyes. Dry eye syndrome is a broad term to describe these symptoms but it is important to identify the cause of this condition. Dry eye can be either due to aqueous deficiency or evaporative causes from meibomian gland dysfunction. Aqueous deficiency is when the gland in the eye that is responsible for producing tears (called lacrimal gland) stops producing enough tears. This can be a result of certain medical conditions like diabetes or autoimmune conditions including rheumatoid arthiritis or lupus or certain types of medications like those for high blood pressure, acne or birth control pills. Other glands called meibomian glands are present in our upper and lower lids and produce the oily layer of our tear film. This oily layer is the outermost of the 3 layers of the tear film and prevents the watery aqueous middle layer from evaporating quickly. When the meibomian glands get blocked due to inflammation and do not produce the oily layer, the tears do not stick on the surface of the eye long enough and that causes evaporative dry eye.
Determining the cause of the dry eyes helps identify the ideal treatment plan including the type of artificial tears that will be most effective for a patient. One important difference between various artificial tears is the presence or absence of preservatives. Some contain preservatives, most commonly benzalkonium chloride (BAK) while others do not. One study found that BAK can be toxic for sensitive corneas and reduce tear production. If used as directed, 3-4 times a day, for patients that do not have a hypersensitivity to preservatives, it would be acceptable to use those types of artificial tears. However, most of our doctors recommend the use of preservative free lubricating drops. We carry certain i-med pharma products at our clinics and are happy to recommend other preservative free options as well.
Another differentiating factor for artificial tears is the viscosity. Some are watery, while others are more viscous, gel-form. For nighttime use, depending on the severity of the dry eyes, our doctors may also recommend a thicker ointment. The thicker the product, the longer it will stay on the surface of the eye providing relief. Although artificial tears are an important piece of the treatment for dry eye disease, your optometrist may recommend additional procedures like lid wipes and warm compresses, omega 3s, prescription drops, punctual plugs, and radiofrequency treatment. For more information on non-invasive radio frequency treatment, check out our event coming up this Thursday, July 9th with Dr. Nikki! If you have any questions about artificial tears, dry eyes, or the new radiofrequency treatment at Eyes 360, feel free to contact us or ask us at your next visit!