In recent years, the incidence and impact of dry eye disease has come to dominate the artificial tear market as more stakeholders—including eye-care professionals, general medical personnel, and patients—have recognized the need for better treatments for this condition.
What is increasingly lost in this conversation is the tremendous scope of artificial tear applications, important uses that go beyond the traditional diagnosis of dry eye disease. While many of these may fall loosely under the rubric of dry eye, the diversity in etiology, symptomology, and presentation create a diagnostic jigsaw puzzle that is often solved by a recursive trial of one drop or another.
Some clinicians may resort to simplifying this problem by choosing a single product to recommend—a one-size-fits-all approach.
However, as the diversity of drop products expands and the understanding of the nuances of various ocular surface maladies increases, it seems worthwhile to consider the differences between drop products and how these might make one drop a better choice for a given patient.
A classic example of fitting the artificial tear product to the patient is symptomatic dry eye following corneal surgical procedures.
Some patients experience a temporary, partial loss of corneal sensation that can impact normal blink reflexes. This can lead to an incomplete lid closure during sleep, corneal surface exposure, and a significant burning or foreign object sensation upon awakening. In these patients, an ointment or gel formulation at bedtime can provide the overnight ocular surface protection that a traditional drop cannot match.