Improving the Health of the Ocular Surface With Artificial Tears

When choosing an artificial tear to optimize the ocular surface and visual acuity, I look for one that minimizes blur and remains on the eye for a long time. I have a few top choices, but recently, I have favored a hyaluronic acid-based tear (Blink Tears; Abbott Medical Optics Inc., Santa Ana, CA) that is clinically proven to reduce blur and moisturize the cornea for at least 1 hour (data on file with Abbott Medical Optics Inc.). Blink Tears came on the market in 2008. My patients like this product because it treats all types of dry eye, both aqueous-deficient and evaporative dry eye etiologies. The hyaluronic acid, which is found naturally in the eye, performs the main moisturizing and lubricating function. In my experience, a tear containing hyaluronic acid relieves both the subjective and objective symptoms of patients. Many artificial tears will only treat the subjective symptoms, such as burning and scratchiness, but in my patients, Blink Tears has significantly improved corneal staining with lissamine green. I recommend this product to all of my dry eye patients, but some need supplemental treatment. I instruct these patients to use Blink Tears four-to-five times daily to treat their symptoms and to administer Restasis (Allergan, Inc., Irvine, CA) twice a day, as a means to increase the production of aqueous and treat the underlying problem. Occasionally, a patient may have evaporative dry eye, in which case I will also prescribe oral omega-3s and blepharitis treatment (eg, warm compresses, lid hygiene, and pulsed therapy with topical azithromycin as needed). A tear containing hyaluronic acid, however, is my basic choice for treatment in all dry eye patients.