Dry eye lubrication

Dry eye represents the most common ocular dysfunction presenting to primary eye practitioners.

Dry eye is a global problem that now seems to have reached epidemic proportions.1 Dry eye is a problem for around one-third of all patients with increased prevalence rates associated with age, gender, and ethnicity.1, 2 Further contributing factors can include: a hot dry climate, air conditioned environments, digital screen usage, contact lenses, ophthalmic surgery, and certain medications.

It can be a constant problem and sufferers can experience a myriad of symptoms including burning, irritated, red eyes; a gritty, sandy sensation; vision disturbances; and difficulties wearing contact lenses. All of these can interfere with daily activities such as reading, watching television, driving, and enjoying the outdoors. This can be incredibly frustrating for patients, especially as there is no cure for the disease. In addition to daily symptoms, if left untreated, dry eye disease can potentially damage the eye and even affect sight. Understandably, sufferers want to find effective relief for their symptoms and improve their quality of life.

Dry eye is a complex disease with various internal and external factors which can result in a disturbance of homeostasis of the tear film and ocular surface. It can occur when the tear film is compromised by reduced aqueous tear production, excessive tear evaporation, or a combination of the two.

  • Aqueous Deficiency Dry Eye Disease is caused by a lack of aqueous tear secretion which results in a concentrated and unstable tear film. This form of dry eye represents a smaller proportion (14.5%) of dry eye patients than previously thought and as the disease progresses, patients can also develop Evaporative Dry Eye Disease. 3
  • Evaporative Dry Eye Disease is the most common type of dry eye according to clinic and population based studies (49.7%).1,3 It is caused by an increase in tear evaporation due to an abnormal tear film lipid layer or Meibomian Gland Dysfunction.
  • More than one third of dry eye disease is a combination of Aqueous Deficiency Dry Eye and Evaporative Dry Eye (35.8%). Patients with a combination of both tend to have a more severe form of dry eye. 3

A key take home message is that there is no ‘magic bullet’ for treating dry eye. Management of symptoms vary considerably for different patients. However, pharmacists have an opportunity to play a key role in helping to understand contributing factors and manage this chronic condition – ultimately assisting in improving patients’ quality of life.

With the overwhelming number of different eye drops sitting on shelf, it can be a difficult minefield to navigate through – which one is most appropriate for the patient?

For the long-term management of dry eye, preservative-free eye drops are recommended to avoid irritations and adverse reactions in the eye. Unfortunately preservatives are often added to multi-dose preparations to increase their shelf-life, but there are preservative-free, multi-dose eye drops available in Australian pharmacies.

The HYLO® range has a unique delivery system that enables high quality preservative-free drops, and NovaTears® is water-free, which means there is no microbial growth possible, and no need for preservatives.

NovaTears® (Perfluorohexyloctane 100%, 3mL) is a new, unique preservative-free eye lubricant and tear film stabiliser in a multi-dose bottle, specifically designed for the relief of Evaporative Dry Eye and Meibomian Gland Dysfunction. It utilises patented EyeSol® technology to provide an innovative water-free mode of action that acts as a lubricating lipid layer stabiliser and evaporative barrier for improved tear film stability and quality. NovaTears® spreads quickly and easily on the eye with a long lasting effect for greater patient satisfaction. It has a pleasant warm silky feeling with no blurring, stinging, or burning. NovaTears® contains no preservatives, phosphates, or surfactants, and can be used for 6 months after opening.

HYLO®-Fresh and HYLO-Forte® eye drops provide relief for dry eyes through a systematic approach that is centred on a revolutionary multi-dose device. The patented COMOD® application system protects the sodium hyaluronate solution from contaminated ambient air, and ensures the precisely measured delivery of at least 300 sterile drops without the use of preservatives. This ingenious system ensures use for up to 6 months after opening and with at least 150 treatments (both eyes) it provides at least 5 times more treatments per pack than single-use preservative-free drops currently available in Australian pharmacies.*

HYLO®-Fresh eye drops (sodium hyaluronate 0.1% w/v, 10mL) offer long-lasting lubrication for dry eyes of moderate or medium severity, while the increased concentration of sodium hyaluronate in HYLO-Forte® (sodium hyaluronate 0.2% w/v, 10mL) results in a higher viscosity solution for long-lasting, intensive and soothing relief of severe or chronic dry eye. Both products are suitable for use following surgery and can be used with all contact lenses.

During sleep, tear production also comes to a halt, so using an eye ointment can provide night time protection. VitA-POS® (retinol palmitate 138 ug/g, 5g) is a smooth, sterile, and preservative-free eye ointment that stabilises the tear film and keeps all forms of dry eyes lubricated by preventing tear evaporation. The retinol palmitate (equivalent to 250 IU/g of Vitamin A) is well tolerated by the eye, supports the physiological tear film, and assists the easy spreading of the ointment across the eye surface. VitA-POS® is also phosphate –free, and can be used for up to 6 months after opening with more than 300 individual applications possible in each tube.

This preservative-free range provides tailored monotherapy or combination therapy options for the specific dry eye needs of your patients.

For more information about NovaTears®, HYLO®-Fresh, HYLO-Forte®, and VitA-POS®, contact AFT Pharmaceuticals on 1800 2387 4276 or visit www.aftpharm.com

* Based on the largest available pack size of single use preservative-free eye drops available in Australia as at 1st August, 2018.

1. Stapleton, F., Alves, M., Bunya, V.Y., Jalbert, I., Lekhanont, K., Malet, F., Na, K.S., Schaumberg, D., Uchino, M., Vehof, J. and Viso, E., 2017. TFOS DEWS II Epidemiology Report. The ocular surface, 15(3), pp.334-365.
2. Craig JP. “A Contemporary Approach To Dry Eye Management”. MiVision 2014; 96: 53-58.
3. Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea. 2012 May 1;31(5):472-8.

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