Artificial tears (Artificial tears) is a pharmaceutical product that has been manufactured for use as lubricant eye. Used to treat and relieve dry eyes due to the lack of tears. Including irritation in the eyeball Or used to lubricate the eyeball while wearing contact lenses, etc. Artificial tears produced will have properties similar to natural tears. There are three types of artificial tears products for sale in Thailand: solution (there are multiple doses containing preservative and unit dose without preservatives), gels and ointments, each of which has advantages. And the disadvantages vary.
In general, artificial tears fall into the category of modern drugs, external drugs. Not belonging to the active ingredient, narcotic or controlled drug But for some, the trade name is registered as a dangerous drug for external use. However, the use of artificial tears is safe and effective for treatment. Remains only under the guidance of a healthcare professional.
The main components of artificial tears in solution and gel form are: Eye lubricant and moisturizer such as methyl cellulose. (Methylcellulose), carboxymethyl cellulose (Carboxymethyl cellulose – CMC), hydroxyethyl cellulose (Hydroxyethyl cellulose – HEC), hydroxypropyl cellulose (Hydroxypropyl cellulose – HPC), hydroxypropyl methyl cellulose. (Hydroxypropyl methylcellulose – HPMC), Dextran, Polyvinyl alcohol (PVA), Polyethylene glycol. (Polyethylene glycol – PEG), sodium hyaluronate (Sodium hyaluronate), carbomer (Carbomer), etc. It also contains buffers.(Buffer), a mixture that helps balance the other elements in artificial tears. Regulate the pH of the artificial tears to fit and match the pH of the tears. Causing no stinging when instilling And help maintain the condition of artificial tears such as boric acid (Boric acid) and sodium borate (Sodium borate) , a tightening agent. To adjust the osmolarity of artificial tears to the tears. That is very popular. Sodium chloride , electrolyte or other components to help make artificial tears the properties most similar to natural tears, such as Glycine, Calcium chloride, Magnesium chloride. Rides (Magnesium chloride), Potassium chloride (Potassium chloride), Sodium lactate (Sodium lactate), Zinc (Zinc) etc. Preservative .To help artificial tears maintain their condition and prevent the growth of microorganisms that may become contaminated during instillation. It can be stored for one month after opening the bottle, such as benzalkonium chloride. (Benzalkonium chloride)
As for the wax form of artificial tears, it contains lubricants and moisturizers for the eyes, such as lanolin, white petrolatum, mineral oil, etc., and may You can add or not add preservatives to the product.
Artificial tears
Artificial tears have trade names such as Alcon Tears Naturale Free (Alcon Tears Naturale Free), Alcon Tears Naturale 2 (Alcon Tears Naturale ll), Cellu Fresh M. D / Celluvise MD (Cellufresh MD / Celluvisc MD), Cellufresh / Celluvise (Cellufresh / Celluvise), Duratears (Duratears), Endura (Endura), Gentian. Gels (Genteal Gel), Hialid, Isopto Tears, Lac-Oph, Lacryvisc, Lipo Liposic, Liquifilm, Natear, Opsil Tears, Offal-Tears (Optal-Tears), Optical-Free Pure Moist (OPTI-FREE Puremoist), Optive, Refresh (Refresh), Tear mac, Whistlub Arti. Vislube artificial tear for One day, Vidisic Gel, etc.
Types and differences of artificial tears
- Artificial tears in the form of a solution in bottlesof 5, 15 and 30 ml.
- This form of artificial tears is suitable for people with mild dry eyes and is convenient for regular use.
- It has a market price that is much cheaper than the one-day stick solution.
- Easier to use than gel and ointments, non-greasy eye patches can be applied during the day without blurring the eyes. But there are disadvantages: It has to be used more often than gel and ointments.
- Multiple eye drops can be used. Because there is a preservative in the recipe It can be used for about 1 month after opening the bottle for the first time.
- Add preservatives Which may cause allergic reactions or eye irritation in some patients Because the preservative destroys the cells lining the cornea
- After each use, drop the drug. If the medicine bottle is not tightly closed or the medicine is not completely stored It can easily be contaminated from the environment. When using this form of drug, caution must be exercised when storing and applying the eye drops for the next time. To prevent the following eye infections
IMAGE SOURCE: pantip.com (by noopin) , www.sabuyjaizone.com: artificial tears Nat Gauthier (Natear) 10 ml price 140 baht, artificial tears Gauthier McCormick (Tear mac) 10 ml prices. About 80-120 baht
Artificial Tears Cellu Fresh MD (Cellufresh MD), size 15 ml, price about 165 baht, artificial tears , Alcon Opt- Free (Alcon OPTI-FREE), size 10 ml, price about 140-180 baht, artificial tears , Klens . 100 (Clens 100) size 8 ml, approx. 110-115 baht, Lac-Oph artificial tears , 10 ml, approx. 60 baht
- Monodose eye drops are used in single-day useor daily artificial tears (Monodose eye drops) in 0.3, 0.4 and 0.8 ml tubes, 20-60 tubes per box.
- This form of artificial tears is suitable for people with a history of hypersensitivity to preservatives in artificial tears or who need frequent eye drops, as prolongeduse of preservatives can lead to cell destruction. The lining of the cornea
- It has a higher price than the first model. This type of artificial tears containers are divided into small rods or tubes, which can be divided into portions of the desired number of drops. And convenient for daily use
- Easier to use than gel and ointments, non-greasy eye patches can be applied during the day without blurring the eyes. But there are disadvantages: It has to be used more often than gel and ointments.
- Each instill of the drug will produce the same amount of artificial tears for each drop.
- No preservatives Therefore, it is valid within 24 hours after first use. But there are advantages: Giving you a more comfortable feeling Can help reduce the chance of eye allergies, preservatives (But still may be allergic to artificial tears viscosity) and less likely to be contaminated by external impurities
IMAGE SOURCE: goods-pharmacy.lnwshop.com, www.pharmashop4u.com: Vislube artificial tears 0.3 ml per tube (1 box contains 20 tubes, the price is about 485 baht per box)
IMAGE SOURCE: www.discountdrugstores.com.au: Artificial Tears, Cellufresh, 0.4 ml per tube (1 box contains 30 tubes, approx. 378-405 baht per box)
IMAGE SOURCE: www.terapeak.com, pantip.com (by SomaOh): Alcon Tears Naturale Free Artificial Tears, 0.8 ml per tube (1 box contains 32 tubes, price per box) About 365-400 baht)
- Artificial tears, gel form and eye ointment, 3.5 g packaging.
- They are more viscous than artificial tears in the form of aqueous solution, bottle and stick, used for one day. Therefore, the frequency of use of the drug is less than those two forms
- With a higher viscosity This slows the evaporation of the water, thus helping to retain moisture for the eyes longer. Therefore suitable for use by moderate to severe dry eyes
- Can be used for a long time according to the regulations in the package of each pharmaceutical company But the drug must be stored after opening with caution. To prevent contamination from the environment
- They tend to interfere with vision more than the first two forms of artificial tears, which may cause blurred vision after instillation or smearing. Therefore recommended to use during bedtime For those who use contact lenses should not use this form of artificial tears. This will interfere with vision and may degrade the quality of contact lenses.
- In the recipe, the composition of lanolin, white petrolatum or mineral oil may be found, which helps to stabilize the waxy film of artificial tears on the eye surface. Longer Thus giving a feeling of gooey eyes
IMAGE SOURCE: www.mims.com: Video acid gel (Vidisic Gel) artificial tear gel 10 g, about 90-130 baht.
Properties of artificial tears
- Keeps the eyes moist Lubricate the eyeball In people with dry eye symptoms, there are fewer tears (generally found in older people whose lacrimal glands work less with age. Especially in postmenopausal women This includes those who have to work in front of the computer for a long time, causing less blinking than usual. When you feel it is irritated or stinging and you close your eyes and rest, your symptoms will not improve. It may be necessary to use artificial tears to relieve symptoms) or in people suffering from dry eyes due to thermal radiation. (Often found in people working in the sun, exposed to a lot of wind or working in hot and dry weather It will cause the vitreous fluid to evaporate more than normal) and those at risk of dry eye such as Bell’s paralysis, bulging eyes in patients with toxic goiter.
- Used to lubricate the eyeball after cataract surgery or after LASIK.
- (LASIK)
- Used to relieve eye irritation caused by dust and cigarette smoke.
- Helps relieve symptoms of corneal ulcers. (Corneal inflammation)
- Helps relieve corneal abrasions.
- It is used as an aid in treating symptoms of glaucoma.
- Some artificial tears are formulated for use with contact lenses.
Mechanism of action of artificial tears
Most artificial tears, or intraocular lubricants, are mechanically acting by acting like a film or membrane and have a self-viscosity. Causing grip and lubrication of the eye surface Thus reducing irritation and helping to feel comfortable in the eye after instillation of artificial tears
Before using artificial tears
When prescribing all kinds of drugs, including artificial tears. Here are some things to tell your doctor or pharmacist:
- History of allergy to artificial tears and all other drugs, especially eye drops. Including the symptoms of such drug allergy such as drops, pain, stinging or irritation etc.
- Various underlying diseases and prescription and over-the-counter medications Including dietary supplements, vitamins, and various herbal drugs that are currently or are currently being used. Because artificial tears may exacerbate the symptoms of the underlying disease. Or drug interactions with other drugs and / or other dietary supplements (But usually, artificial tears are an external drug used on the eye Therefore, there is very little information on drug interactions with oral drugs. Except for using artificial tears in combination with other eye drops because artificial tears can interfere with the absorption of eye drops. If need to be used together Each drug should be instilled at least 10 minutes apart.)
Contraindications / precautions for the use of artificial tears
- Do not use drugs that have expired or are worn out. In particular, artificial tears that have changed color from the original manufacturer’s standards.
- Do not reuse artificial tears designed for one day use. And if you can’t use all of the eye drops, discard them after use.
- Do not share artificial tears with others. To prevent infection from others
- There is currently no data on the effects of artificial tears in pregnant or lactating women and in children. Because artificial tears are local drugs In this group of patients, the doctor will consider and decide to use on a case-by-case basis.
- Beware of allergy to components of artificial tears such as antibacterial agents or preservatives. (Preservatives)
How to use artificial tears
- In general, artificial tears have the following dosage, drug administration and dosage methods.
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- For dry eyes Slight eye irritation Use eye drops 1-2 drops each time 3-4 times a day (artificial tears in a bottle type solution. Usually it should not be used more than four times a day as the preservatives it contains can irritate the cornea.)
- For severe dry eyes Use eye drops 1-2 drops each time, 10-12 times a day (doctor’s prescription only).
- For artificial tears, gel and ointment forms. Give the drug a sign 1-2 times a day in the morning and before going to bed. (If used once a day, it is recommended to smear the eyes before going to bed)
- How to use artificial tears (method of use, drop method How to label artificial tears) for the patient to do as follows
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- Wash your hands
- Look up at the angle that works best. Then use one hand to gently pull the lower eyelid down into a bulb or bulge to open the area of the implant.
- Glance up And place the tip of the artificial tear tube in a position far from the eye Then squeeze the medicine tube of artificial tears to drop the medicine into the eye area with the other hand The number of drops is to be used as directed by the treating physician. Typically 1-2 drops (should be careful not to touch the tip of the artificial tears around the eye or face. Or touch the fingertips, hands or any part of the body To prevent microbial contamination to grow in the drug)
- Then close your eyes and roll your eyes around for a few minutes while tilting your head so that artificial tears don’t flow from your eyes.
- Wipe any excess medicine that has dripped outside the eye with a clean towel or paper.
- Wash your hands after dropping your eyes thoroughly. Because keep in mind that the infection can be in the other eye. If a dirty hand touched the eyelid or oozed into the other eye.
- After instilling artificial tears Frequent blinking should be avoided to prevent artificial tears from draining from the eye faster. And use your fingers to gently roll around the corner of the eyelid to help spread the artificial tears all over the eye.
IMAGE SOURCE: www.allaboutvision.com
Tips for using artificial tears
- Selection of each type of artificial tears has to be considered appropriate for daily use. If the patient is comfortable using the eye drop type multiple times during the day Should choose to use artificial tears in the form of solution, bottle type or stick for one day use. Because both products are less viscous Therefore less distraction than the gel and eye ointments. But on the other hand If you are inconvenient to use it during the day, avoid using gel and eye ointments. Using the eye tag 1 time a day before bedtime
- The instillation size, as well as the frequency of daily dosing depends on the active substance in each brand of artificial tears. Patients should use this drug as directed by their physician. Along with a thorough understanding of how to use from the drug package
- Artificial tears used by people who wear contact lenses. Should be a recipe for contact lenses in particular.
- For contact lens wearers, the use of artificial tears with preservatives that may cause the destruction of corneal epithelial cells, such as benzalkonium chloride, should be avoided for contact lens wearers. (Benzalkonium chloride) because contact lenses can absorb this substance and expose the corneal mucosa to it for a long time. Therefore may damage the cells lining the cornea Therefore, contact lens wearers should opt for monodose eye drops, monodose eye drops, or artificial tears with a less toxic epithelial preservative such as Stabilized oxychloro complex (Purite®). ), Polyquaterium-1 (Polyquad®) a compound between Boric acid, Zinc, Sorbital and Propylene glycol (SofZia ™), but if necessary, artificial tears containing benzalkonium chloride. (Benzalkonium chloride) contact lenses should be removed before instillation of artificial tears. Then wear contact lenses about 10 minutes after putting in the eyes.
- If artificial tears must be used in combination with other eye drops They should be spaced at least 10 minutes apart.
- Persons with severe and chronic dry eyes should consult an ophthalmologist for diagnosis and treatment of the underlying cause.
- If you experience any abnormal symptoms after using the drops, such as severe eye irritation. Stop using the drug immediately and consult an ophthalmologist.
Storage of artificial tears
- Keep this medication in the original container it came in, tightly closed, and kept out of the reach of children and pets.
- For aqueous solution-type artificial tears Keep in the refrigerator at temperature between 15-25 degrees Celsius and should not be used for more than 1 month. Keep at temperature between 15-30 degrees Celsius.
- For single-day implantable tears When opened Should be used within 24 hours.
- Keep the drug away from direct sunlight and heat. And do not store the drug in a wet or damp area Because heat or humidity can cause drug quality deterioration.
- Discard any drug that is worn out or has expired. (No matter what type of artificial tears or eye drops If the service life has passed, the remainder should be discarded immediately. Due to possible bacterial contamination)
When I forget to use artificial tears
If you forget to drop the drug, instill the drug as soon as you remember it. But if it is close to the next time You can skip to drop the drug at the next time. Without the need to increase the dose twice or more than usual
Side effects of artificial tears
- May cause poor vision. Mild eye irritation Cause light allergy Has symptoms similar to watery eyes Swelling of the eyelids Which side effects may be caused by other substances that are co-elements in the drug formulation, such as drug viscosity enhancer, preservative,
