Definition
In medical terms, ocular dryness is known as "ocular xerosis": we are talking about a disorder affecting the eye and the conjunctiva that, degenerating, causes a progressive surface keratinization, thus compromising vision. In ocular xerosis there is a lack of mucus secretion by the conjunctiva, as well as insufficient tearing, therefore unable to ensure a correct degree of humidity inside the eye.
Causes
Eye dryness is essentially caused by insufficient tearing: we briefly recall that tears are essential to ensure a certain moisture in the eye and protect it from infection. The factors most involved in the onset of dry eyes are: imbalance in the composition of tears (water, electrolytes, mucus ...), inability to produce tears, diabetes, lupus, scleroderma, thyroid abnormalities, vitamin A deficiency, refractive surgery eye, laser eye surgery, alteration of lacrimal glands, Sjögren's syndrome.
- Risk factors: advanced age, environmental pollution, smoking, some drugs (antidepressants, antihistamines, painkillers, acne medications, birth control pills)
Symptoms
Eye dryness is responsible for damage to the surface of the eye: normally, the problem manifests itself with discomfort, itching and ocular inflammation, and then progresses with eye fatigue, circumscribed burning, difficulty in 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
Information on Ocular Dryness - Drugs 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 Eye Dryness - Drugs for the Treatment of Xerosis Ocular.
drugs
For the vast majority of patients complaining of dry eyes, the rather simple treatment of choice consists in the administration of over-the-counter drugs (eye drops). When the phenomenon is recurrent and the ocular dryness causes alterations in the sight - even slight - it is recommended to seek medical attention for a thorough specialist check-up: we have seen, in fact, that dry eyes can be a symptom of serious illnesses, therefore the diagnosis early will be useful to verify a possible underlying disease. To underline that the treatment clearly depends on the cause that originated the disorder: to give an example, even the administration of some drugs can induce a dryness at the level of the eye, therefore, in this specific case, it is simply necessary to replace the medicine to restore optimal eye condition. If the ocular dryness was an indicator light of abnormalities 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 inflammation and dry eyes depend on bacterial insults; ocular xerosis can also be controlled by administering drugs that act as immune suppressors, or formulated with corticosteroids. In some cases, it is necessary to intervene with ocular inserts capable of slowly releasing artificial tears.
If the drugs do not show any observable benefit in the patient, the last therapeutic option is surgery or thermal cauterization.
Eye drops for the treatment of ocular xerosis:
- Hypromellose (eg. Tioretin): is the pharmacological treatment of choice for the treatment of minor dry eyes. In order to get relief of symptoms in a short time, frequent administration of the drug is recommended, about an application every hour for the first days of therapy.
- Acetylcysteine (eg Tirocular, Brunac): it is possible to apply this mucolytic drug in the form of eye drops, in association with the hypromellose, in the eye 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 eyes depending exclusively on a deficiency 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% (ex. Lacrimalfa); sodium chloride eye drops are indicated for people with ocular xerosis who wear contact lenses. As we have seen, in fact, dry eyes can prevent the correct positioning of contact lenses, creating discomfort and localized tingling. Furthermore, sodium chloride can be a good aid for removing contact lenses in patients who complain of dry eyes.
- Polyvinyl alcohol (eg Hypotears): the drug is indicated to prevent the 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 the product in the diseased eye (or 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 posology suggests to instill in the eye 2 drops of drug 2-4 times a day, in full respect of what is indicated by the doctor. The drug is often formulated with polyvinyl acid, in order to improve ocular moisture.
- Naphazoline (eg. Pupilla, Collirio Alfa, 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 with dry eyes. 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 promote lubrication of the eye, particularly when dry eye damages the corneal epithelium. It is recommended to apply the ointment just before bedtime, since the drug can cause a temporary blurred vision. Do not apply with contact lenses.
Antibiotics for dry eye dependent on bacterial infections:
- Oxitetracycline and polymyxin: the combination of these two antibiotics in the context of dry eye is indicated in case of ocular superinfections. It is recommended to apply a drop in the eye or in both affected by dry eye once a day. The duration of therapy should be determined by the doctor.
- Ciclosporina (eg Restasis, a drug marketed only in America): instill a drop of drug in the eye or in sick eyes, every 12 hours. Continue with this dosage until symptoms are remitted. The drug is indicated to counteract the inflammation of tear-producing glands in the context of dry eyes.
Systemic drugs for the treatment of dry eye:
- Pilocarpine (eg Dropilton, Piloca C FN, Salagen): this drug, administered orally, is indicated to treat eye pain in the context of severe eye dryness (xerophthalmia: ocular xerosis due to vitamin A deficiency)
- Vitamin A or retinol (eg. Adisterolo, Evitex, Vitalipid): dry eyes can be a lit indicator of a vitamin A deficiency. In this case, the diagnostic assessment is essential to promptly intervene and avoid the progression of dry eye in xerophthalmia . Therefore, vitamin A supplementation is recommended, according to the instructions given by the doctor.
