Page 78 - Community pharmcy practice E-book 2025

02/11/2025, 00:10 Otic & Ophthalmic Disorders | Dermatological Disorders

Therapy

lubricants

Artificial tears (Eye drops)

Ointment

Gel

Artificial tears products vary by viscosity in accordance with the ingredients used in their preparation.
With these products, higher viscosity allows more prolonged ocular contact time and greater resistance
to tear dilution.
Mild cases of dry eye disease may show improvement with less viscous products, whereas more severe
cases may require more viscous products.

Ophthalmic Ointments & Gels

Blank (i.e., nonmedicated) ophthalmic ointments (e.g., petrolatum) or gels are other types of ocular
lubricants.
Because ointment preparations tend to cause blurred vision, they typically are reserved for use only at
bedtime or for severe cases of dry eye.
As with ointments, the more viscous the artificial tears are, the greater their blurring effect becomes.
Gels offer some clinical advantage in that they disturb vision less compared with ointments and are
better tolerated by the patient.
Vitamin A preparations
Vitamin A preparations also are available for treating dry eye disease.
Artificial Tears composition

Ocular lubricants: Viscosity imparting agents: hydrophilic polymers & Mineral or vegetable oil

Osmo-protectants: Bio-compatible solutes offer an additional layer of protection beyond simple
lubrication through restoring osmotic pressure of ocular cells.

Excipients: Preservatives, antioxidants, wetting agents, buffers, and tonicity adjusters.

A. Viscosity imparting agents
Substituted cellulose ethers, which include hydroxypropyl methylcellulose 0.3%–0.8% and
carboxymethylcellulose (CMC) 0.5% and 1.0%. CMC 1% often is classified as a "gel" because of its
higher viscosity.

Polyvinyl alcohol (PVA) 1.4%, povidone 0.6%–2.0%, polyethylene glycol 400, propylene glycol 0.3%–
0.6%, and glycerine 0.5%–1.0% are other vehicle commonly used as ocular lubricants.

Sodium hyaluronate is viscosity imparting agent, and it may also promote healing of the corneal
epithelium.

77