Polyacrylic Acid Gel in Patients with Dry Eyes: A Randomised Comparison with Polyvinyl Alcohol

1998 ◽  
Vol 8 (2) ◽  
pp. 81-89 ◽  
Author(s):  
A.J. Bron ◽  
H. Mangat ◽  
M. Quinlan ◽  
A. Foley-Nolan ◽  
P. Eustace ◽  
...  
Keyword(s):  
Dry Eye ◽  
Polyacrylic Acid ◽  
Global Assessment ◽  
Tear Film ◽  
Signs And Symptoms ◽  
Blurred Vision ◽  
Dry Eyes ◽  
Local Tolerance ◽  
Daily Frequency ◽  
Acid Gel

Purpose To compare the safety and efficacy of polyacrylic acid 0.2% (PAA) gel and polyvinylalcohol 1.4% (PVA) in the treatment of patients with dry eyes. Methods Eighty-nine patients with dry eyes were randomly allocated to treatment with either PAA (48) or PVA (41) in a prospective, investigator-masked study in two centres. The parameters assessed were daily frequency of instillation of the study medications, ocular signs and symptoms, tear film break up time, Schirmer's test values, local tolerance and global assessment of the improvement following treatment. Results The two groups were similar in patient demographics and study parameters at baseline. The total score of symptoms (gritty or foreign body sensation, burning sensation, dry eye sensation, photophobia, others) and signs (conjunctival hyperaemia, ciliary injection, corneal and conjunctival epithelial staining) was reduced significantly more by treatment with PAA than with PVA at both three and six weeks (p<0.0001). The daily frequency of instillation of PAA was significantly less than that PVA on 38 of the 41 (93%) study days. Both PAA and PVA were safe and equally well-tolerated except for blurred vision, usually mild and transient, on PAA. On global assessment of the improvement in their dry eye condition, significantly more PAA patients felt better on treatment at six (p=0.02) weeks compared with those on PVA. Conclusions Polyacrylic acid gel was as safe as and more effective than polyvinylalcohol in the treatment of patients with dry eyes.

scholarly journals Determination of Risk Factors and Treatment of Dry Eye Disease in Type 1 Diabetes Before Corneal Complications at Sindh Institute of Ophthalmology And Visual Sciences

2017 ◽  
Vol 11 (1) ◽  
pp. 355-361 ◽  
Author(s):  
Shehnilla Shujaat ◽  
Muhammad Jawed ◽  
Shahzad Memon ◽  
Khalid Iqbal Talpur
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Dry Eye ◽  
Tear Film ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Diabetic Patients ◽  
Dry Eyes ◽  
Department Of Ophthalmology

Objective: The objective of this study was to assess and determine the risk factors and treatment of dry eye disease in type 1 diabetes before any ocular surface or corneal complication occurs. This study was conducted at Sindh Institute of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Methodology: Subjects and methods for observational study were undertaken at the Department of Ophthalmology Sindh Institute Of Ophthalmology And Visual Sciences, Hyderabad, Pakistan. Hundred confirmed cases of type 1 diabetes were included in the study by non probability convenience sampling. Tear film breakup time and schrimer test were carried out to determine dry eye disease. Data was collected by self-prepared questionnaire and entered and analyzed by using Statistical Program for Social Sciences (SPSS, version 20.0). The frequencies and percentage were recorded and any associations with predisposing factors were statistically analyzed by t test. Results: Out of hundred patients, 71 (71%) were found to have dry eyes (P<0.001). The mean age of the subject in this study was 50.97 years (range 30-70 years). Old age was related to high risk of dry eye disease (P<0.001). There was no big difference in the incidence of dry eyes in males and females. Long duration was found to be related with increased occurrence of dry eyes (P<0.001). We found higher values for abnormal tear film break up time than schirmer test values leading to increased occurrence of evaporative dry eyes. Conclusion: There is marked increase in frequency/ risk of developing dry eye disease in type 1 diabetes patients. Therefore, it is recommended to have periodic ophthalmic examination for type 1 diabetic patients.

scholarly journals CORRELATION BETWEEN UREA LEVELS IN LACRIMAL FLUID AND PATHO-PHYSIOLOGY OF DRY EYE SYNDROMES

2020 ◽  
pp. 1-3
Author(s):  
Anil Sharma ◽  
Narendra Kumar Keisham ◽  
Archana Sharma
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Test Group ◽  
Sample Volume ◽  
Dry Eye Syndromes ◽  
Dry Eyes ◽  
Urea Level ◽  
Lacrimal Fluid ◽  
Schirmer’S Test ◽  
Single Centre Study

Introduction : In the ocular surface there is a well- coordinated system of enzymes that can produce urea independent of external urea supply. Urea locally formed from ocular tissues is important for the composition of the tear fluid. In eyes with dry syndromes this production is affected. Estimation of urea levels in the lacrimal fluid may prompt a newer treatment for dry eyes utilising urea. This study was done to evaluate the correlation between serum urea levels and pathophysiology of dry eye syndromes. Materials and methods: A prospective, observational, single-centre study. 50 patients of dry eye disease were included in the subjects and 50 controls were included in the study based on schirmer’s test. Tear film urea was estimated wih semi autoanalyser erba chem 5. When sample volume was not sufficient it was diluted with sterile water and urea was estimated after calculating for dilution factor. Blood urea was estimated with Erba Chem EM 360 working on similar principle Results: In the test group, the urea level in tear film ranged from 14.01 mg % to 39 mg % with a mean of 26.78 +/- 5.70 mg %. In the controls the levels of urea in the tear film ranged from 21.06 mg% to 56.00 mg% with a mean of 41.72±6.86 mg%. Conclusions: Levels of urea in tear film in normal individuals without dry eyes is similar to urea levels in the blood. Tear film urea levels were significantly lower in patients with dry eye diagnosed with Schirmer’s Test. Decreased tear film urea level in dry eyes is unrelated to blood urea levels and may play a role in the pathophysiology of dry eyes. This needs further investigation.

scholarly journals Effects of warm compress on tear film, blink pattern and Meibomian gland function in dry eyes after corneal refractive surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xueyi Zhou ◽  
Yang Shen ◽  
Jianmin Shang ◽  
Xingtao Zhou
Keyword(s):  
Dry Eye ◽  
Corneal Thickness ◽  
Tear Film ◽  
Meibomian Gland ◽  
Blink Rate ◽  
Lipid Layer ◽  
Dry Eyes ◽  
Mean Values ◽  
Before And After ◽  
Gland Function

Abstract Background To assess the effects of warm compress (WC) on tear film lipid layer, blink pattern and Meibomian gland function in patients with dry eye following femtosecond laser small incision lenticule extraction (SMILE) and laser-assisted subepithelial keratomileusis (LASEK). Methods We enrolled 37 eyes of 37 participants, each with dry eye for more than 2 years following SMILE (25 eyes) or LASEK (12 eyes). WC was performed using a spontaneously heating eye mask. Tear film break-up time (TBUT), tear film lipid layer thickness (TFLLT), blink pattern, Meibomian secretory function scores (MGS), visual acuity, spherical equivalent (SE), keratometry, central corneal thickness (CCT) and aberration were assessed before and after WC. Results After WC, the following mean values all increased relative to baselines: CCT, SE, minimum (Min-), maximum (Max-) and average (Ave-) TFLLT, TBUT, total MGS (TMGS), number of glands secreting any liquid (MGL), and complete blink rate (CBR) (p values ranging from < 0.001 to 0.042). Partial blink frequency (PBF) and partial blink rate (PBR) decreased (p = 0.002 in both cases). The decrease of PBF was higher in SMILE subgroup than in LASEK (p = 0.030). TBUT variation was positively correlated with that of Ave-TFLLT and TMGS (p = 0.046, 0.028, respectively). Max-TFLLT variation was correlated with that of TMGS (p = 0.020). Conclusions WC may temporarily increase tear film thickness and stability, decrease partial blink, and partly augment Meibomian gland function in dry eye patients after corneal refractive surgeries. Future studies are required to investigate long term clinical efficacy and safety.

scholarly journals Tear Metabolomics in Dry Eye Disease: A Review

2019 ◽  
Vol 20 (15) ◽  
pp. 3755 ◽  
Author(s):  
Mazyar Yazdani ◽  
Katja Benedikte Prestø Elgstøen ◽  
Helge Rootwelt ◽  
Aboulghassem Shahdadfar ◽  
Øygunn Aass Utheim ◽  
...  
Keyword(s):  
Dry Eye ◽  
Early Stage ◽  
Clinical Signs ◽  
Tear Film ◽  
Current Method ◽  
Signs And Symptoms ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Health And Disease ◽  
Clinical Signs And Symptoms

Dry eye disease (DED) is a multifactorial syndrome that can be caused by alteration in the quality or quantity of the precorneal tear film. It is considered one of the most common ocular conditions leading patients to seek eye care. The current method for diagnostic evaluations and follow-up examinations of DED is a combination of clinical signs and symptoms determined by clinical tests and questionnaires, respectively. The application of powerful omics technologies has opened new avenues toward analysis of subjects in health and disease. Metabolomics is a new emerging and complementary research discipline to all modern omics in the comprehensive analysis of biological systems. The identification of distinct metabolites and integrated metabolic profiles in patients can potentially inform clinicians at an early stage or during monitoring of disease progression, enhancing diagnosis, prognosis, and the choice of therapy. In ophthalmology, metabolomics has gained considerable attention over the past decade but very limited such studies have been reported on DED. This paper aims to review the application of tear metabolomics in DED.

A study to assess the efficacy of topical cyclosporine A 0.05% in the management of dry eye with meibomiam gland dysfunction

2022 ◽  
Vol 7 (4) ◽  
pp. 667-671
Author(s):  
Prajwalli Reddy ◽  
Wajeeha Umam
Keyword(s):  
Dry Eye ◽  
Cyclosporine A ◽  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Control Group ◽  
Dry Eyes ◽  
Group A ◽  
Group B

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p &#60; 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p&#60;0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P&#60;0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.

scholarly journals Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients

2019 ◽  
Vol 8 (2) ◽  
pp. 211 ◽  
Author(s):  
Akiko Hanyuda ◽  
Masahiko Ayaki ◽  
Kazuo Tsubota ◽  
Kazuno Negishi
Keyword(s):  
Cataract Surgery ◽  
Dry Eye ◽  
Ocular Surface ◽  
Bright Light ◽  
Signs And Symptoms ◽  
Clinical Tests ◽  
Blurred Vision ◽  
Body Sensation ◽  
Ocular Fatigue ◽  
Fatigue Sensitivity

Despite the increased awareness of early prophylaxis and treatment for dry eye disease (DED) during the first few weeks after cataract surgery, the chronic effect of cataract surgery on the risk of ocular surface abnormalities has not been fully explored. This study was to assess the prevalence of DE subjective symptoms and clinical tests according to the cataract surgery. A total of 172 patients who underwent bilateral cataract surgeries at least 5 months before the recruitment date and 1225 controls with no cataracts were evaluated for their subjective DE symptoms (dry sensation, foreign-body sensation, ocular pain, ocular fatigue, sensitivity to bright light, and blurred vision) and ophthalmic parameters (tear break-up time, keratoconjunctival staining scores, and maximum blinking interval). The presence of subjective DE symptoms was generally inversely associated with cataract surgeries, whereas abnormal clinical tests were more pronounced among postsurgical cataract patients than among controls. Pseudophakic patients showed a 57% increased prevalence of severe keratoconjunctivitis, compared to controls (P = 0.02). In contrast, among subjective DE symptoms, significantly lower odds of sensitivity to bright light were detected among cases than controls; the multivariable-adjusted odds ratio (95% confidence interval) comparing pseudophakic patients with noncataract patients was 0.56 (0.34–0.92) (P = 0.02). In conclusion, persistent tear instability and corneal epitheliopathy were found even at several months or more after cataract surgery. This study demonstrates the importance of evaluating ocular surface conditions in pseudophakic patients, even if they lack DE symptoms.

scholarly journals MPC Polymer Promotes Recovery from Dry Eye via Stabilization of the Ocular Surface

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 168
Author(s):  
Noriaki Nagai ◽  
Shunsuke Sakurai ◽  
Ryotaro Seiriki ◽  
Misa Minami ◽  
Mizuki Yamaguchi ◽  
...  
Keyword(s):  
T Cell ◽  
Dry Eye ◽  
Therapeutic Potential ◽  
Rabbit Model ◽  
Tear Film ◽  
Relevant Information ◽  
Corneal Epithelial Cell ◽  
Epithelial Cell Line ◽  
Dry Eyes ◽  
Lacrimal Fluid

The polymer that includes 2-methacryloyloxy ethyl phosphorylcholine (MPC) is well-known as an effectively hydrating multifunction agent. In this study, we prepared an MPC polymer (MPCP) using radical polymerization with co-monomers—MPC/Stearyl Methacrylate/N,N-dimethylacrylamide—and evaluated the MPCP’s usefulness for dry eye treatment using a rabbit model treated with N-acetylcysteine. The MPCP particle size was 50–250 nm, and the form was similar to that of micelles. The MPCP viscosity (approximately 0.95 mPa·s) was 1.17-fold that of purified water, and a decrease in the transepithelial electrical resistance value (corneal damage) was not observed in the immortalized human corneal epithelial cell line HCE-T cell (HCE-T cell layer). The MPCP enhanced the water maintenance on the cornea, and the instillation of MPCP increased the lacrimal fluid volume and prolonged the tear film breakup time without an increase in total mucin contents in the lacrimal fluid of the normal rabbits. The therapeutic potential of the MPCP for dry eye was evaluated using an N-acetylcysteine-treated rabbit model, and, in our investigation, we found that MPCP enhanced the volume of lacrimal fluid and promoted an improvement in the tear film breakup levels. These findings regarding the creation and characteristics of a novel MPCP will provide relevant information for designing further studies to develop a treatment for dry eyes.

scholarly journals Patients Preference of Diquafosol or Rebamipide Eye Drops for the Treatment of Mild Dry Eye: A Pilot Study

2018 ◽  
Vol 1 (1) ◽  
pp. 39-45
Author(s):  
Maria Yamamoto ◽  
Yukihiro Horie ◽  
Yoshiaki Tagawa ◽  
Susumu Ishida ◽  
Nobuyoshi Kitaichi
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Ophthalmic Solution ◽  
Signs And Symptoms ◽  
Eye Drops ◽  
Subjective Assessments ◽  
Significant Difference ◽  
Related Quality ◽  
Old Females

Purpose: To investigate the preference rates of recently developed eye drops, 3% diquafosol ophthalmic solution and 2% rebamipide ophthalmic suspension, as a randomized clinical trial in patients with dry eye.Methods: Eighteen patients (mean age: 59.7 years old, females: 77.8%) with reduced tear film break-up time (TBUT ? 5 sec) were enrolled in this study. They were treated with either diquafosol or rebamipide for 1 week, and treated for an additional week after switching to the other eye drop. This treatment was repeated one more time. Then, the patients were treated with one of either eye drop for an additional 4 weeks. Patients’ preferences for eye drops were investigated using a questionnaire at the end of 4-week treatment. To confirm the effectiveness of the treatments, objective and subjective assessments including superficial punctate keratopathy (SPK) score, TBUT measurement, and Dry Eye-Related Quality-of-Life Score (DEQS) were performed at baseline, and 4 and 8 weeks.Results: SPK score was improved after treatment (P < 0.05). Patients tended to prefer diquafosol (64.7%) torebamipide (35.4%), however there was no significant difference in two eye drops (P = 0.23). Bitterness was reported significantly more frequently after rebamipide administration (66.7%) than diquafosol administration (5.6%, P < 0.001). The diquafosol bottle was considered “ease to use” by a larger percentage of users (94.1%) as compared to the rebamipide bottle (58.8%, P < 0.05). The effectiveness of the signs and symptoms were similar for both groups at 8 weeks.Conclusions: Diquafosol and Rebamipide were both effective in treating dry eye and 65% of the patients choose Diquafosol. Bitterness after administration and ease to use of the bottles seemed to affect the patients’ preferences for these two eye drops.

scholarly journals Meibomian Gland Dysfunction

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Sameera Irfan
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Treatment Strategies ◽  
Tear Film ◽  
Meibomian Gland ◽  
Dry Eye Disease ◽  
Meibomian Gland Dysfunction ◽  
Eye Disease ◽  
Treatment Protocols ◽  
Dry Eyes

Dry eyes is a common, chronic condition that has a prevalence of about 5- 50%.1 According to the Dry Eye Workshop II report (DEWS II report), published in 2017, the updated definition of Dry Eye Disease is, “a multifactorial disease of the ocular surface characterised by a loss of homeostasis of the tear film, and accompanied by ocular symptoms, in which tear film instability and hyper-osmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles.” The Tear Film & Ocular Surface Society (TFOS) released their report on the international work on Meibomian Gland Dysfunction (MGD)2 in 2011, which defined MGD, classified it and considered it as the primary cause of dry eye disease worldwide. Previously dry eye disease was considered as an aqueous deficiency problem, but after this report by TFOS, there is a paradigm shift towards “not producing enough lipids to retain the tears that are being produced”. This has led to a huge impact on the treatment protocols which were previously focused on managing the sequelae and symptoms of dry eyes rather than targeting directly on the underlying cause, the MGD. It has now been accepted worldwide that dry eye occurs when the ocular surface system cannot adequately protect itself from the desiccating stress due to the lack of a healthy meibomian gland secretion. This article is mainly focussed on the Meibomian Gland Dysfunction, discussing the normal anatomy of the glands, how they are affected by disease, its implications on the ocular surface and finally, the various treatment strategies. Key words: Blepharitis, Dry eyes, Meibomian gland dysfunction, blepharospasm.

scholarly journals A comparative study of efficacy of chloroquine phosphate 0.03% and sodium carboxymethylcellulose 1% in dry eye

2021 ◽  
Vol 7 (2) ◽  
pp. 302-307
Author(s):  
Vandana Sharma ◽  
Parag Tyagi ◽  
J P Chugh ◽  
R S Chauhan ◽  
Ashok Rathi
Keyword(s):  
Drug Therapy ◽  
Comparative Study ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Eye Drops ◽  
Onset Of Action ◽  
Dry Eyes ◽  
Ocular Symptoms ◽  
Group 2

Dry eye disease (DED) is a multifactorial disease of the tear film which leads to ocular discomfort, visual disturbances and damage to ocular surface. The objective of treatment of DED has now shifted from managemnt of ocular symptoms and patient relief to attainment of normal physiological composition of the tear film.Aim of this study was to compare the efficacy of chloroquine phosphate 0.03% (CQP) eye drops with sodium carboxymethyl cellulose 1% (CMC) eye drops in the management of DED. A single blind, prospective and comparative study including 100 patients of dry eyes was planned. The patients were randomly divided into two groups, each comprising of 50 patients. Group-1 patients were given CMC 1% eye drops 4 times a day for 12 weeks and Group-2 patients were given CQP 0.03% eye drops as the treatment modality 2 times a day for 12 weeks. The efficacy of both the drugs was compared and evaluated statistically. The study showed that both CQP and CMC eye drops are effective in treating DED, although faster onset of action was observed with CQP on ocular surface staining tests and Schirmer’s test. Also, it was noted that patients with severe DED showed least improvement in both the groups suggesting that mono-drug therapy is least effective in treatment of severe DED and multi drug therapy should be used early in treatment of severe DED.

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