Definition
In medical terms, dry eye is known as "ocular xerosis": we are talking about a disorder affecting the eye and conjunctiva which, degenerating, causes a progressive superficial keratinization, thus compromising vision. lack of mucus secretion by the conjunctiva, that insufficient lacrimation, therefore unable to ensure the right degree of humidity inside the eye.
Causes
Dry eyes are essentially caused by insufficient lacrimation: let us briefly remember that tears are essential to ensure a certain moisture in the eye and protect it from infections. The factors most involved in the onset of dry eye are: imbalance in the composition of tears (water, electrolytes, mucus ...), inability to produce tears, diabetes, lupus, scleroderma, thyroid disorders, vitamin A deficiency, refractive surgery eye, laser eye surgery, tear gland alteration, Sjögren's syndrome.
- Risk factors: old age, environmental pollution, smoking, some medications (antidepressants, antihistamines, pain relievers, acne medications, birth control pills)
Symptoms
Dry eye is responsible for damage to the surface of the eye: normally, the problem manifests itself with eye discomfort, itching and inflammation, and then progresses with eye fatigue, limited burning, difficulty wearing contact lenses, overproduction of tears , hypersensitivity to light, thickening of the conjunctiva, blurred vision, perception of sand inside the eye, production of thick and filamentous mucus around the eye.
Progression of ocular xerosis: xerophthalmia → corneal xerosis → keratomalacia → trachoma → dry plaques and scarring of the cornea and conjunctiva
The information on Dry Eye - Medicines for the Treatment of Ocular Xerosis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Dry Eye - Medicines to Treat Ocular Xerosis.
Medicines
For the vast majority of patients who complain of dry eyes, the rather simple treatment of choice is the administration of over-the-counter drugs (eye drops). to go to your doctor for a thorough specialist check-up: we have seen, in fact, that dry eyes can be a symptom of even serious diseases, so early diagnosis will be useful for verifying any underlying pathology. It should be emphasized that the treatment clearly depends on the cause that originated the disorder: to give an example, even the administration of some drugs can induce dryness in the eye, therefore, in this specific case, it is simply necessary to replace the medicine to restore the optimal ocular condition. If the dry eyes were a light on of anomalies in the eye, rheumatoid arthritis or lupus, the choice towards which to direct the treatment will obviously be different.
Generally speaking, it is possible to apply antibiotics locally (in the form of ointments or eye drops) when the inflammation and dryness of the eye depend on bacterial insults; ocular xerosis can also be controlled with the administration of drugs that act as immuno-suppressants, or formulated with corticosteroids In some cases, it is necessary to intervene with ocular inserts able to slowly release artificial tears.
If the drugs do not report any observable benefit to the patient, the last therapeutic option is surgery or thermal cauterization.
The following are the classes of drugs most used in the therapy for dry eye, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Eye drops for the treatment of ocular xerosis:
- Hypromellose (eg. Tioretin): is the drug treatment of choice for the treatment of mild dry eye. In order to obtain relief of symptoms in a short time, a frequent administration of the drug is recommended, approximately one application every hour for the first days of therapy.
- Acetylcysteine (eg Tirocular, Brunac): it is possible to apply this mucolytic drug in the eye in the form of eye drops, in association with hypromellose, in order to restore the superficial mucin layer of the eye, clearly altered by local xerosis. With the combination of acetylcysteine + hypromellose it is possible to reduce the frequency of administration of the product (one every 4 hours).
- Povidone (eg. Oculotect): the administration of this drug is indicated for dry eye exclusively dependent on a deficit in the production of tears. It is recommended to apply the drug 3-4 times a day, or as needed. Consult your doctor.
- Sodium Chloride 0.9% (eg. Lacrimalfa); a sodium chloride-based eye drops are indicated in subjects suffering from ocular xerosis who wear contact lenses. As we have seen, in fact, dry eyes can prevent the correct positioning of contact lenses, creating localized discomfort and tingling. Furthermore, sodium chloride can be a good aid for the removal of contact lenses in patients who complain of dry eyes.
- Polyvinyl alcohol (eg Hypotears): the drug is indicated to prevent ocular mucus from being removed from its seat. It is recommended to administer the drug in case of alteration of the composition of the ocular mucus in the context of ocular xerosis. It is advisable to instill one or two drops of product in the sick eye (or in both); repeat the application 3-4 times a day.
- Fluorometolone (eg. Fluaton): the drug is a corticosteroid indicated for the treatment of dry eye accompanied by acute and subacute inflammation of the anterior ocular segment. The dosage suggests to instill in the eye 2 drops of the drug 2-4 times a day, in full compliance with what is indicated by the doctor. The drug is often formulated with polyvinyl acid, in order to improve ocular humidity.
- Naphazoline (eg Pupil, Alpha Eye Drops, Iridina DUE): the drug is an antihistamine-decongestant, also used in therapy to treat the symptoms of ocular xerosis. It is recommended to instill 1-2 drops of the drug in the eye affected by dry eye. Repeat the application 3-4 times a day, as needed.
Topical ointments for the treatment of dry eyes:
- Paraffin (eg. Lacrilube ophthalmic ointment): paraffin-based ointments are indicated to favor the lubrication of the eye, particularly when dry eye affects the epithelium of the cornea. It is recommended to apply the ointment just before bedtime, as the drug can cause temporary blurring of vision. Do not apply with contact lenses.
Antibiotics for bacterial infection-dependent dry eye:
- Oxitetracycline and polymyxinB: the combination of these two antibiotics in the context of dry eye is indicated in the case of ocular superinfections. It is recommended to apply one drop in the eye or both affected by dry eye, once a day. The duration of therapy must be determined by the doctor.
- Ciclosporin (eg. Restasis, a drug marketed only in America): instill a drop of drug in the eye or in the diseased eyes, every 12 hours. Continue with this dosage until the symptoms are resolved. The drug is indicated to counteract the inflammation of the glands that produce tears in the context of dry eye.
Systemic drugs for the treatment of dry eyes:
- Pilocarpine (eg. Dropilton, Piloca C FN, Salagen): this drug, administered orally, is indicated to treat eye pain in the context of severe dry eye (xerophthalmia: vitamin A deficiency ocular xerosis)
- Vitamin A or retinol (eg. Adisterol, Evitex, Vitalipid): dry eye can be an indicator of a vitamin A deficiency. In this case, the diagnostic assessment is essential to intervene promptly and avoid the progression of dry eye in xerophthalmia Therefore, a supplementation of vitamin A is recommended, according to the indications dictated by the doctor.
