Relief is in Sight

Contributed by: Tammy Stack, Pharm.D.

Community Pharmacy Resident

$Text Box: Do you ever have dry, itchy, eyes? Your pharmacist can help you find solutions to relieve the symptoms of dry eyes. What are the symptoms of Dry Eye? Symptoms of dry eye include white or mildly red eye, a sandy or gritty feeling, or the sensation of having an object in one's eye. The problem may initially present as an excessive tearing in the eye. What causes Dry Eye? Many things can cause dry eye including aging, eyelid defects, loss of tissue stiffness, Sjőgrens' syndrome, Bell's palsy, various collagen diseases, some medications, and refractive surgery. Dry eye can be made worse by dry, dusty conditions. What is the treatment of Dry Eye? The best treatment plan is to first determine the cause of dry eye, and then to alleviate and control dryness, to relieve irritation, and prevent possible tissue and corneal damage. Treatment options available include ocular lubricants such as artificial tears, non-medicated ophthalmic ointments and gels, lid scrubs, and warm compresses. Artificial tears contain cellulose ethers, polyvinyl alcohol, or povidone to help lubricate the eye. Cellulose ethers such as hydroxypropyl methyl cellulose or carboxymethyl cellulose work by stabilizing the tear film and slowing down evaporation, and by increasing thickness of tears which reduces tear drainage. Polyvinyl alcohol (PVA) works by enhancing the stability of the tear film. Povidone forms a water-like layer on the corneal surface, and mimics natural mucin found in the eye. How do I use artificial tears? Artificial tears are used 1-2 times daily, but can be used up to 3-4 times daily. See product directions for the number of drops. Guidelines for Using Eyedrops 1. Wash hands thoroughly. 2. Tilt head back 3. Gently grasp lower outer eyelid below lashes, and pull eyelid away from eye to create a pouch. 4. Place dropper over eye by looking di$

Text Box: rectly at it. 5. Just before applying a single drop, look up. 6. Avoid touching the tip of the dropper to the eye. 7. As soon as the drop is applied, release the eyelid slowly. Close eyes gently for 3 minutes by placing you head down as though looking at the floor (using gravity to pull the drop onto the cornea). Minimize blinking or squeezing the eyelid. 8. Use a finger to put gentle pressure over the opening of the tear duct. 9. Blot excessive solution from around the eye. 10. If more than one drop is needed, wait at least 5 minutes before instilling the next drop. This helps to ensure that the first drop is not flushed away by the second, or the second drop is not diluted by the first. 11. If using a suspension, place that drop in last. 12. If both drop and ointment therapy are indicated, instill the drops at least 10 minutes before the ointment so the ointment does not become a barrier to the drops' penetrating the tear film or cornea. Guidelines for Using Eye Ointments 1. Wash hands thoroughly. 2. If both drop and ointment therapy are indicated, instill the drops at least 10 minutes before the ointment so that the ointment does not become a barrier to the drops' penetrating the tear film or cornea. 3. Tilt head back. 4. Gently grasp lower outer eyelid below lashes, and pull eyelid away from eye to create a small pouch. 5. Place ointment tube over eye by looking directly at it. 6. With a sweeping motion, place 1/4 to 1/2 in. of ointment inside the lower eyelid by gently squeezing the tube but avoid having the tube touch any tissue surface. 7. Release the eyelid slowly. 8. Close eyes gently for 1 to 2 minutes. 9. Blot excessive ointment from around the eye. 10. Vision may be temporarily blurred. Avoid activities requiring good visual ability until vision clears.

Text Box: Which products can I use to relieve dry eye? Some examples of products which are considered artificial tears are: Rhoto Zi Moisture Eyes HypoTears Refresh Liquigel Genteal Tears Naturale If these over-the-counter preparations do not help, there are prescription medications such as Restasis® which can be prescribed by your physician. What are some side effects of dry eye preparations? Some of the eye preparations are incompatible with contact lenses. Check with your eye care practitioner to see which products are best for you if you wear contact lenses. Some people are sensitive to the preservatives which can be found in eye preparations. There are single use products such as Refresh Celluvisc and Moisture Eyes PM which are preservative-free. What else can I do to relieve my symptoms? Other ways of treating dry eye include manipulating your environment. For instance, don't smoke or inhale second hand smoke, and avoid direct wind and air conditioning. Use of a humidifier, especially in winter, is useful. Throughout the day, purposefully blink more often and give your eyes rest periodically. Be sure to drink plenty of water to keep your body hydrated, and get plenty of sleep so eyes are well rested. Also eat healthy foods containing eye nutrients vitamins A, C and E.

Continued on next page