EYE HEALTH


DRY EYE SYNDRomE IS oNE of thE moSt commoN mINoR hEAlth AIlmENtS YoU’ll ENcoUNtER AS A phARmAcISt. It cAN, howEVER, BE EASIlY tREAtED


Not A DRY EYE… D


ry eye syndrome, or dry eye disease, is a common condition that occurs when


the eyes don't make enough tears, or when tears evaporate too quickly. As a result, eyes can dry out and become red, swollen and irritated.


It’s not known exactly how many people suffer from this condition, but it is estimated that up to ten per cent of the general public is affected. perhaps unsurprisingly, it tends to affect older people more frequently, with thirteen per cent of sufferers in their 50s and as many as one in three sufferers over 70 years of age.


Dry eye tends to begin when the tear film – the thin liquid layer that lubricates the eyes – fails to do its job effectively. this can be caused by: • Being in a hot or windy climate • wearing contact lenses • certain underlying medical conditions such as blepharitis (inflammation of the eyelids


• hormonal changes in women (dry eye affects women more than men)


Unfortunately, certain medications such as antihistamines, antidepressants and beta blockers can also cause dry eye. As a result of the natural lubrication process being compromised, the eyes become dry and may feel gritty and uncomfortable.


other symptoms of dry eye can include: • pain that may become worse during the day


34 - phARmAcY IN focUS


• A feeling of burning in the eyes • Redness of the eye • Eyelids stuck together on wakening • temporary blurred vision which tends to improve with blinking


fortunately, for most people, the symptoms of dry eye syndrome are mild, although more severe cases can be painful and can lead to complications.


tREAtmENt there is no ‘cure’ for dry eye problems, but the symptoms can be controlled. the treatment depends very much on whether symptoms are caused by decreased production of tears, tears that evaporate too quickly or by an underlying condition.


As a pharmacist, the first thing you need to consider when a patient presents with obvious dry eye syndrome is whether it is being caused by medication that they may be taking. If that is the case, then they should be referred back to their gp. Similarly, if you suspect that the condition is being caused by an underlying condition, then the patient should be referred to their gp, as they can then refer the patient to an appropriate specialist.


for those patients, who appear to be simply suffering from dry eye syndrome, then the condition can usually be treated with over-the- counter (otc) lubricant eye treatments, which are available in drop, gel and ointment form.


these lubricants are often called artificial tears because they replace the missing water in the tear film. however, they don't contain the antibodies, vitamins and nutrients found in normal tears that are essential for eye health.


ARtIfIcIAl tEAR DRopS these are synthetic, water-based solutions that are used to lubricate the eye and ‘thicken’ the tears. the drops are usually formulated as solutions or suspension and vary in viscosity. these drops can contain preservatives, which are designed to prevent harmful bacteria growing inside the medicine bottle. these preservatives, if used in large quantities, or over a prolonged period of time, may damage the delicate cells on the surface of the eye, or may cause inflammation.


Even if not used over a prolonged period of time, some patients will develop a sensitivity to the preservatives and this can lead to redness, burning or itching. In these cases, it’s advisable to recommend that the patient uses preservative-free eye drops.


Recent research has found that hyaluronic acid and tamarind seed polysaccharide (tSp) can be very effective in the treatment of dry eyes. hyaluronic acid is a naturally occurring polymer, which has the capacity to bind up to 3000 times its own weight in water. As such, it can help to reduce evaporation and, consequently, fluid loss from the eyes.


tSp is another muco-adhesive polymer, which is naturally occurring in the body. It produces a visco-elastic solution, which is similar to mucins: important proteins on the surface of the eye.


the combination of the two ingredients means that they mimic the behaviour of natural tears, which obviously reduces the symptoms of dry eye.


other treatments include:


'oIlY' tEAR EYE DRopS these are drops which replenish the oily part of the tear film and reduce evaporation from the surface of the eye. these preparations are also otc and include synthetic guar gums and liposomal sprays, which are sprayed on to the edges of the eyelids when the eyes are closed.


oily tear drops are particularly useful for patients with blepharitis or dry eye syndrome, which is caused by tears evaporating too quickly.


EYE oINtmENtS/EmollIENtS these products contain lubricating ingredients, which are similar to petroleum jelly. the main advantage that they have over water-based solutions is that they tend to remain in the eye longer.


they tend to be used overnight because they can cause blurred vision. patients, who wear contact lenses can’t use the ointments while they are wearing their lenses.


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