![]() ![]() On the shelf, salad dressing separates into an oil and water layer, and shaking is required to mix the dressing into an emulsion prior to use. On the tear film the structure of castor oil allows it to spread rapidly and act to fortify the lipid layer, where it can reduce evaporative fluid loss.Įmulsions are a mixture of oil and water. It is widely used in cosmetic and dermatological products, and has a long safety history. Castor oil is a polar oil, mostly consisting of the triglyceride of ricinoleic acid (see Figure 1). Refresh Endura is an artificial tear that contains a castor oil emulsion. The left end is hydro-philic and the right end is hydrophobic It is principally a triglyceride of ricinoleic acid. Refresh Endura: An Emulsion-Based Eye Dropįigure 1. Allergan"s Restasis, a cyclosporine, received FDA approval just last month. Other pharmacological approaches under study include use of androgen analogs such as DHEA 6 or topical testosterone to stimulate trophic receptors on all of the lacrimal glands, and use of cyclosporine 7 or corticosteroid treatment 8 to modulate the inflammatory components of dry eye disease. These compounds propose to stimulate mucin and aqueous secretion from the ocular surface itself. One category is the secretagogues such as INS365 (Inspire Pharmaceuticals) 3, 15(s)-HETE (Alcon Labs) 4, and OPC-12759 (Otsuka Pharmaceuticals) 5, which are at various stages of clinical and preclinical testing. On the horizon, there are several pharmacological treatments being developed that are designed to address some of the causes of dry eye. These palliative measures can alleviate symptoms, but many patients obtain only temporary relief, essentially because the cause of their disease is not being addressed. Primarily what we can offer are palliative treatments such as artificial tears and punctal occlusion. Because of the inconsistency between signs and symptoms, we feel that regardless of the presence of signs, our primary goal of treatment must be to address our patients" symptoms.Īt this point in time, many of our treatments are only partially effective dry eye cannot be "cured" like we can cure an infection. ![]() On other occasions, patients have very marginal staining and normal TBUT, but experience severe dryness symptoms. ![]() Many times, we have seen patients present with signs such as moderate bulbar staining and low break-up time (TBUT), but with no complaint of symptoms whatsoever. 1,2 For the practitioner as well as the patient, dry eyes can be a complicated problem, with a number of confusing factors. D ry, irritated eyes are one of the most common symptoms of patients, and dryness and resulting discomfort are the most prevalent reasons patients give for discontinuation of contact lens wear. ![]()
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