| Tear Supplements | |
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Tear supplements in the form of eye drops, gels, ointments and sprays are important in the management of dry eye at MICHEL GUILLON. The range of products available in the UK alone is in the hundreds and the important first step to improve the dry eye condition and achieve symptom relief is to choose the best product in each individual case. It is therefore not surprising that self prescribing and dosing by patient without successful results is a feature in many patients attending MICHEL GUILLON for dry eye consultation for the first time.
A wide range of products have been selected at MICHEL GUILLON to cover all patients’ needs. The products can be broadly divided into four categories, some products belonging to more than one category:
Aqueous supplementation
The aqueous layer (the watery layer of the tear film) produced by the lacrimal gland constitutes the largest volume of the tear film; certain eye conditions and personal circumstances (e.g. aging) are associated with a decreased tear production. The aqueous layer, however, contains also salts and nutrients essential to its optimal functioning and to the maintenance of an intact ocular surface; compositional anomalies tend to be more common than reduced tear volume.
Traditionally, aqueous supplementation was via the use of viscous eye drops (e.g. polyvinil pyrolidone or polyvinylalcohol eye drops) to achieve a longer lasting effect. Research over the last ten years has shown that the aqueous layer is a very complex structure that has very different properties between and during blink (Non newtonian liquid). At MICHEL GUILLON aqueous supplementation is via a range of non newtonian eye drops.
Mucus supplementation
The mucin layer (often called mucus layers) is a highly hydrophilic (water loving) gel that covers the entire surface of the eye, immediately below the aqueous layer. Its role is to hold a stable and thick aqueous tear film over the epithelia of the cornea and conjunctiva which are hydrophobic (water repellent).
MICHEL GUILLON dry eye examination routine detects the presence of any anomaly of the mucin layer and quantifies its extent and severity. A new generation of eye drops with mucomimetic (mucin like) properties are used to manage dry eye with mucin anomalies.
Lipid supplementation
The lipid layer (the oily layer of the tear film) is a very thin layer (on average 1/1000th of a millimetre) that spreads over the front of the aqueous layer. The layer is in fact a highly complex bi-layer made up of polar lipids (at the surface of the aqueous and which role is to rapidly spread over in an even film) and non polar lipids (at the outer surface of the tear film). The role of the lipid layer is to prevent excessive tear evaporation between blinks and maintain a continuous tear film.
Analysis of the lipid with the The Tearscope during the MICHEL GUILLON dry eye routine examination identifies any anomaly. Two types of anomalies exist: not enough lipids overall or an excessive amount of non spreading non polar lipids both producing similar problems. The management of the problem, which at times involves the use of lipid eyedrops or spray, is customised depending upon the type of anomaly present.
Anterior ocular inflammation
Long term dry eye is often associated with chronic low grade eye inflammation, typified by hyperaemia (increased redness) linked to a hypertonic (excessive salt concentration) tear film. The management at MICHEL GUILLON involves the use of eye drops to offset the abnormal tear concentration. |
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