Finding the best eye drops to treat dry eyes

Patients often ask in our clinics, which are the best eye drop for dry eyes? There are a lot of drops and many treatments available, and the market is only increasing in size, further subdivided into niche categories within the dry eye space. As we understand the processes and the causes of dry eye better, more targeted, specific treatments are being developed.

It is definitely a challenge to find the best eye drops to treat dry eyes. Patients jump from drop to drop hoping to find the cure. Unfortunately, there are as many reasons a patient suffers from dry eye as there are dry eye drops and treatments available, there is no one solution. You could go with the averages, 80% of patients with dry eye have evaporative dry eye, leaving the eye dehydrated and uncomfortable. Without going into the many causes of the evaporative issue, a replacement drop to provide you with what you are not providing is a good place to start. In the market, dry eye drops are either aqueous based (tear film replacement/substitution), oil based (improve the tear quality) or a mixture of both. The majority of patients do not have any serious underlying conditions that leave them with dry eye symptoms irrespective of what they do, e.g. Sjogren syndrome, so self management is possible.

It is pretty much accepted universally that eye drops with preservatives are in fact problematic in themselves. While over time not all preservatives are toxic to the eye, manufacturers steer clear of using preservatives where possible and so should you.

Increased computer use and digital devices in general, compounded by our current restricted/indoor lifestyles are all contributing to the incidence of dry eye. Even wearing our face mask, deflecting a warm breath over our eyes has in itself increasing the incidence of dry eyes in the population. Patients will often comment when they switch to a new dry eye drop, initially they feel it is super effective, only to slowly reduce in efficacy, leading to more frequent installation and finally ineffective. 

Like I mentioned dry eyes have many underlying reasons and thus finding a single drop to cure symptoms as they occur is probably not possible. When the underlying cause can be as varied as excessive use of digital devices, reduced blink rate, dry/air-conditioned environments, dietary intake of dehydrating agents, general lack of hydration, allergies, face-masks etc

Trehalose is a novel, naturally found sugar in certain animals and plants, that has some unique properties. It is found abundantly in nature and protects plants from long periods of dehydration, protecting the plant from drying out in harsh arid environments. Trehalose forms a cocoon type structure around the plant cells protecting them until the plant rehydrates and flourish once again. Trehalose has been introduced by Thea pharmaceuticals into its dry eye drops in combination with a lubricant sodium hyaluronate which our body naturally produces, i.e. Thealoz Duo. Similarly, it works by protecting cornea cells from desiccation and periods of high osmolarity by fortifying the epithelial cells on the front surface of the cornea and preventing them from denaturing in the absence of sufficient tear film. 

Insufficient tears is the obvious reason someone has uncomfortable evaporative dry eyes, but when the cornea has dead epithelial cells on its surface the real discomfort begins. Our corneas are super sensitive due to the large number of densely packed nerve fibres. So while the white of our eye can look red and inflamed it actually causes very little discomfort, contrary to the cornea the sclera has very few nerve fibres. Hence you can touch the white of your eye without any great affect whereas touching your cornea is a different matter.

Thealoz Duo eye drops are a preservative free eye drop with 3% Trehalose as the active ingredient. It is the most widely used eye drop in Europe and one of our first go to drops in our clinics. It is recommended to be used between 4 -6 times daily, and crucially every day as distinct from days you are aware of the dryness. Research shows repeated consistent use devivers a more effective recovery. Trehalose crucially reduces the death of these front surface epithelial cells on your cornea allowing them to survive in the dry environment only to revive once rehydration is restored. Like the plant in the desert that looks dead only to revive and thrive when the rains come e.g. The Rose of Jericho plant

Thealoz duo comes in a thicker single unit formulation also which we advise patients who often wake during the night or early morning with an uncomfortable dry eye, to instil into the eye last thing at night, before lights out

 Feel free to contact us if you would like more details and if we can help in any way.

Don Stack
Optical Rooms