BLOG: Pros and cons of artificial tears
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The global market for artificial tears was estimated to be $1,609 million in 2018, and it is expected to continue to grow. With so many people buying and using artificial tears, it merits an assessment of their utility.
Pros
When patients need relief from dry eye, they want something that helps now. Artificial tears are readily accessible and inexpensive, making them a good first course of action to take to alleviate the symptoms of dry eye.
Patients report feeling relief upon using them, and I make sure to recommend a good quality artificial tear, including artificial tears without preservatives for certain patients.
Cons
While artificial tears are easily obtained and do provide immediate relief, there are a few drawbacks.
Artificial tears are exactly that, artificial. Each individual generates tears unique to them, just like a fingerprint, and no man-made formula can replicate that. Artificial tears clear out the smoke, but we still need to put out the fire and help patients generate their own, high-quality tears.
While artificial tears provide immediate relief, they don’t treat the underlying cause. For sustained improvement, it is essential that we diagnose and treat the underlying cause.
In most cases there is underlying inflammation that needs to be addressed. Nutraceutical supplements containing omega fatty acids are a logical next step that offers dry eye patients a nonprescription and potentially long-term solution. Taking a pill is relatively easy, and for older patients, it is already part of their daily routine. When pursuing a supplement-based approach, it is important to let patients know that the treatment may take some time before they notice any improvement.
During this ramp-up period, they will need to continue artificial tears, warm compresses or eyelid cleansers as prescribed. Typically within 60 days, patients will notice a decreased dependence on artificial tears and have fewer complaints, a sure sign that they are able to generate their own tears, the ideal and best treatment for dry eye disease.
In more severe cases, the underlying inflammation may need to be addressed with a prescription inflammatory mediator such as cyclosporine (Restasis, Allergan, and Cequa, Sun) or Xiidra (lifitegrast ophthalmic solution 5%, Novartis). It is important to note that these medications also take time to work, and the patient will likely continue using an artificial tear for some time.
In many cases, there is obstruction of the meibomian glands that is preventing them from secreting the needed lipids into the tear film. Lid scrubs, warm compresses and manual massage, or thermo-pulsed devices can all aid in clearing blocked meibomian glands.
Whatever you choose for the next step, it is important to remember that artificial tears are very useful but only provide temporary relief. We must treat the cause of dry, uncomfortable eyes if we truly want to help our patients.
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Artificial Tears Market Report. Orion Market Research. Available at: https://www.omrglobal.com/industry-reports/artificial-tears-market. Accessed May 27, 2020.