Artificial tears are lubricant eye drops used to treat the dryness and irritation associated with deficient

tear production in keratoconjunctivitis sicca (dry eyes).[1] They are also used to moisten contact lenses
and in eye examinations.

Artificial tears are available over-the-counter. Artificial tears are supplemented with other treatments in
moderate to severe forms of dry eyes.

Chemistry

Preparations contain carboxymethyl cellulose,[2] polyvinyl alcohol,[2] hydroxypropyl methylcellulose[2]

(a.k.a. HPMC or hypromellose), hydroxypropyl cellulose[1] and hyaluronic acid (a.k.a. hyaluronan, HA)[3]
They contain water, salts and polymers but lack the proteins found in natural tears. Patients who use
them more frequently than once every three hours[1] should choose a brand without preservatives[1]
or one with non-irritating preservatives.

Effects

Application of artificial tears every few hours[4] can provide temporary relief from the symptoms of dry
eyes. Hydroxypropyl cellulose stabilizes and thickens the precorneal tear film and prolongs the tear film
breakup time.[1]

Usage

Artificial tears usually are the first line of treatment for dry eyes.[5] While mild cases require application
of lubricant drops four times a day, severe cases require more aggressive treatment, such as ten to
twelve times a day.[1] Thicker artificial tears can be used in severe cases, although these may
temporarily blur vision.[1]

Precautions

Drops for red eyes can make the eyes drier.[5] If wearing contact lenses, rewetting or lubricating drops
specifically for contact lenses should be used.[5] Other types of drops may contain ingredients that
damage contact lenses.[5]

Adverse effects, interactions and contraindications

Possible adverse effects of carboxymethyl cellulose and similar lubricants include eye pain, irritation,
continued redness, and vision changes.[1] Use should be discontinued if any of them occur.[1] Side
effects of hydroxypropyl cellulose include hyperaemia, photophobia, stickiness of eyelashes, discomfort,
and irritation.[1] However, the overall side-effect profile of artificial tears is very low.[2]
Artificial tears have no reported interactions.[1] A documented contraindication of artificial tears is
hypersensitivity.[1]

Veterinary uses

Artificial tears are a part of the topical therapy for keratoconjunctivitis sicca for animals such as dogs,
cats and horses.[6]

Research

A 2016 Cochrane Review seeking to compare the effectiveness of various over the counter artificial tears
in treating dry eye. While the review stated that it is unclear which artificial tear formulation works best,
two trials found that 0.2% polyacrylic acid-based tears were more effective in treating dry eye symptoms
over 1.4% polyvinyl alcohol-based tears.[7]

SOURCE: WIKIPEDIA