National Safe Medication Use Month | In the dry autumn, how can we stay away from uncomfortable dry eye symptoms?

The goal of dry eye treatment is to relieve symptoms and protect visual function. Mild and moderate dry eyes are reversible, and the cause should be removed as much as possible while relieving symptoms. The causes of severe dry eyes are complex and most are irreversible. The main goal of treatment is to protect visual function and relieve dry eye symptoms on the basis of reasonable treatment of the primary disease. Common drug treatments for dry eyes are to lubricate the ocular surface and promote ocular surface repair.

1

Artificial tears

The tear film is divided into three layers from the outside to the inside: lipid layer, aqueous layer, and mucin layer. Artificial tears replenish these three layers of the tear film and dilute the soluble inflammatory mediators on the surface of the eye.

1

Artificial tears that supplement the lipid layer include artificial tears containing lipid components and simulated lipid structures. Their main function is to prevent tear evaporation, prolong the coating time of the tear film, and maintain the stability of the tear film.

2

The main components of artificial tears for replenishing the aqueous layer include sodium hyaluronate, carboxymethyl cellulose, hydroxypropyl methylcellulose, polyvinyl alcohol, polyvinyl pyrrolidone, polyethylene glycol and polyacrylic acid, etc. Their main functions are to replenish moisture and lubricate the ocular surface.

3

Artificial tears containing hydroxypropylguanidine that simulates the structure of mucin and increases the adhesion between the tear film and the cornea.

2

Eye drops that stimulate tear secretion

The main drug is a P2Y2 receptor agonist (diquafosol sodium) that promotes mucin secretion. Its mechanism of action is to stimulate the ocular surface epithelial cells to secrete mucin, and it also has a certain promoting effect on the secretion of water and lipids.

3

Eye drops that promote ocular surface repair

Eye drops with fibroblast growth factor, epidermal growth factor, vitamin A and other active ingredients can promote epithelial proliferation and maintain the ocular surface microenvironment. For moderate to severe dry eyes with obvious corneal epithelial damage, appropriate artificial tears should be selected according to the type of dry eyes, and eye drops that promote ocular surface repair should be used in combination (2 to 4 times a day).

4

Ophthalmic serum preparations

Autologous serum and calf blood deproteinized extract ocular preparations contain various biologically active ingredients that promote the repair of the ocular surface epithelium and improve the ocular surface microenvironment. They are suitable for moderate to severe dry eyes caused by multiple factors such as ocular surface epithelial damage and corneal neuralgia.

Treatment options:

Depending on the severity of symptoms

1

Mild dry eyes

Carry out health education and improve the environment and diet, improve sleep quality, reduce psychological burden, and increase physical exercise. Reduce or stop using systemic or local drugs that cause adverse reactions to dry eyes (such as anticholinergic atropine, antihistamine diphenhydramine, antidepressant chlorpromazine, antipsychotic carbamazepine, anti-glaucoma drug timolol, etc.) and various eye medicine preservatives, use artificial tears as needed; use tear secretion promoters topically; and perform eyelid physical therapy when necessary.

2

Moderate dry eyes

In addition to the treatment of mild dry eyes, wet chamber mirror is used; for patients with combined ocular surface inflammatory reaction, local combined anti-inflammatory treatment is performed; for water-deficient dry eyes, lacrimal duct embolization treatment is performed after the ocular surface inflammatory reaction is controlled.

3

Severe dry eyes

On the basis of moderate dry eye treatment, add systemic anti-inflammatory treatment, autologous serum preparation eye drops, wearing therapeutic corneal contact lenses, or choose surgical treatment according to the patient's condition. Pay attention to possible systemic diseases, especially autoimmune diseases, and give multidisciplinary comprehensive treatment after the diagnosis is clear. Pay attention to factors that may cause dry eyes to worsen, such as incomplete eyelid closure, abnormal blinking, severe meibomian gland dysfunction, etc., and give corresponding treatment if any.

Artificial tears are the most widely used medicine for treating dry eyes. There are artificial tears with preservatives (benzalkonium chloride) and artificial tears without preservatives on the market. For long-term use, it is recommended to choose artificial tears without preservatives. Eye diseases require professional doctors to diagnose and give reasonable treatment plans. Patients need to strictly follow the doctor's instructions for treatment.