Tag Archives: dry eye

The Best Artificial Tears to Buy

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The tear film covers the cornea for clear vision and comfort (click on image to enlarge)

What are artificial tears and why are they used?

Artificial tears are lubricants manufactured to simulate the normal tears that coat your eyes.  They come in many different preparations.  They are used by people who have dry eyes due to insufficient tear film from a variety of causes including lid problems, auto-immune disease (like Sjogren’s syndrome), and ageing. 

What are the main types of artificial tears?

Depending on the underlying cause of the dry eye, different types of artificial tears are recommended.  For example, evaporative dry eye is a condition in which the natural oils are missing from the normal tears (usually due to blepharitis).  The lack of oil allows the tears to quickly evaporate from the surface of the eye, leaving it dry.  Therefore, some artificial tears include oils to prevent evaporation.  Examples of artificial tears with oils include Soothe XP, Systane Balance, Refresh Optive and Refresh Digital.

Another cause of dry eye is aqueous deficiency.  That is, the tear glands do not produce enough water to coat the eye. This may be caused by ageing or auto-immune disease.  In this case, hypotonic tears help.  They are labelled, “hypotonic” or “hypo-osmolar.”

Many people have a combination of problems that cause their dry eye, and a combination of artificial tears may help.  Examples of good basic artificial tears include Soothe, Blink, Refresh, and Systane.

Preservatives or no preservatives?

Artificial tears come both with and without preservatives.  Preservatives are used to keep the bottle free of contamination allowing for a prolonged expiration date.  Unfortunately, some people are sensitive to preservatives, especially if drops are required more than 4-times-a-day for comfort.  Therefore, preservative-free tears are made to improve comfort (at the price of a shorter expiration date).  Examples of tears with preservatives includes Systane and Blink Tears.  If there are no preservatives in a preparation of artificial tears, the box is usually labelled clearly.

Why do some artificial tears last longer than others?

Artificial tears come in varying degrees of viscosity or thickness.  The thicker the tears, the longer they last.  However, thicker preparations may blur the vision for several minutes.  The thickest preparations include gels (e.g.  Genteal Gel) and ointments (e.g. Lacrilube Ointment and Sooth Nighttime).  They may be best used at night before sleeping as they coat the eye overnight, making the eyes feel better upon awakening. 

What more can be done for dry eyes?

If artificial tears do not give relief from dry eye symptoms, there are a variety of options.  In patients with evaporative dry eye, flaxseed oil or fish oil supplements by mouth may improve the tear film after a month or so.  Similarly, warm compresses may improve the teat film.  Punctal plugs may be used to block the outflow of tears from the eye.  And prescription eye drops (Restasis and Xiidra) may be helpful to treat aqueous deficiency.  If blepharitis contributes to the dry eye, tea tree oil preparations may also help.   

By Scott E. Pautler, MD 

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Eyelid Hygiene

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What is lid hygiene and why is it important?

Lid hygiene is the routine cleansing and care of the eyelids. It is especially important for people with skin problems such as seborrhea, rosacea, and acne. It is also important to improve comfort and vision in eye problems such as blepharitis and chalazion. Lid hygiene helps to remove oily secretions that build up and interfere with the tear film and also lead to bacterial overgrowth. The key to treating these problems is to routinely clean the eyelids with saline solution warm soaks. For additional comfort, take one flaxseed oil capsule by mouth twice a day.

How do I prepare the saline solution for the warm soaks?

Add 1/4th teaspoon of table salt to two cups (16 ounces) of warm tap water and mix thoroughly. Take care not to make the water so hot that it burns the eyelid as the skin is very thin in this area. Use sterile cotton balls soaked in the saline solution and slightly wrung. Place the moistened cotton ball on the closed eyelids until it cools. Replace with fresh warm cotton balls as needed for a total duration of ten minutes.

For a quicker method use a warm wet wash cloth at the sink. These soaks will dissolve secretions, help soothe burning eyes, and decrease the redness of the lids. It is often necessary to do the eye soaks several times a day for the first week and daily thereafter. A simple alternative to using saline solution is to use warm tap water and a wash cloth to soak the eyelids with or without baby shampoo.

A superior method to apply moist heat effectively to the eyelids is with the use of the Bruder mask.

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Moist heat for eyelid hygiene

 

How do I clean the lashes?

Use a Q-tip moistened with warm salt water or diluted baby shampoo. Gently brush the lashes from the base to the lip of the lashes. The upper lashes can be easily cleaned with the eyelids closed. The lower lashes are more difficult and require extra care. Pull down the lower lid while cleaning these lashes to avoid touching the sensitive cornea (the clear window of the eye). The lashes should be cleansed twice a day for the first week and daily thereafter. Tea tree oil face wipes offer convenience and the added benefit of antibacterial qualities.

By Scott E. Pautler, MD

For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.

Please note: As an Amazon Associate I may earn from qualifying purchases.  You pay no additional fees by accessing the link.  These funds help defray the costs of maintaining this website.  Thank you for your support.

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