Hello everyone this is Dr. Audrey Tai, I am a board certified and fellowship trained LASIK
and cataract surgeon, ophthalmologist and cornea specialist. Welcome back to my channel
- eye channel by eye surgeon. In today's video I would like to talk to you about my top five
Choices of the over-the-counter dry eye drops – these are the artificial tears to treat
dry eye disease. This is not a sponsored video, the products I recommend in this video are
based on my own clinical experience treating dry eye disease patients in my practice, the
in-depth research I did about the science behind the ingredients of different artificial
tears, as well as my personal experience using those eyedrops.
To learn more about my practice you can follow me on Facebook and LinkedIn @DRAudreyTai.
And if you have learned anything new from this video, don't forget to like and share
this video, and subscribe to my channel so you won't miss any new videos I make about
eye health and eye surgery. As a LASIK surgeon and cornea specialist I
often get patients with varying severity of dry eye disease referred to me from other
eye doctors. For each of my patient with dry eye disease, I give them a written customized
treatment plan. All of the treatment plans include one or more Over-the-counter artificial
tears and I specify which type of artificial tears that I recommend. However if you're
going to a pharmacy to choose artificial tears on your own, the choices may be overwhelming.
there are typically more than 20 to 30 different types of artificial tears available over-the-counter,
how do you know which one is the right one for you? In this video I will go over with
you about the science behind my top five picks of artificial tears for treating dry eye disease,
and to help you understand the differences between them and choose the artificial tears
that work the best for you. I have listed the links to my top five artificial tears
in the description down below. If you would like to learn more about the
science behind the ingredients of different artificial tears and why I would recommend
certain artificial tears over other ones, you can check out my video about the science
behind artificial tears ingredients (poin. Without further ado, let's talk about artificial
tears. Artificial tears are intended to supplement
the natural tears that are made by the tear glands in our eyes. The natural tears lubricate
the surface of our eyes by forming a tear film. The tear film has three layers:
most outer layer is called the lipid layer, this layer functions as a protective barrier
to prevent tears from drying up too fast; the middle layer is called the aqueous layer,
this watery layer contains the moisture we need to keep the surface of our eye lubricated;
the most inner layer of our tear film is called the mucin layer, the mucin layer functions
as a bridge to keep the tear film attached to the surface of our eye- it’s called the
cornea, and it is the clear windshield of our eye. An ideal artificial tear should be
able to supplement all three layers of our tear film.
I will also be posting a more in-depth video about the mechanisms of dry eye disease and
different types of dry eyes. So make sure you subscribe to my channel and you won't
miss any of my new videos. I have divided my top five favorite artificial
tears into two groups based on the severity of the dry eye disease: mild to moderate and
moderate to severe. And I will list the top three artificial tears that I recommend for
mild to moderate dry eye disease, as well as my top two picks to treat moderate to severe
dry eye disease. For mild to moderate dry eye disease: Number
3: Systane complete made by Alcon. It comes in a 10 ml bottle and uses polyquad as its
preservative. The reason I like It, is because it uses Nano droplet technology, which is
a type of nanoemulsion drug delivery system using negatively charged submicron sized carrier
particles to provide greater surface area to improve the stability and absorption of
the drop. Also “Systane Complete” addresses all three layers of the tear film as it contains
polyethylene glycol as its active ingredient to form a protective layer over the mucous
membrane on the surface of the eye to provide hydration as well as reducing inflammation.
In addition to that it contains hydroxypropyl guar, AKA HP guar. It is a pH dependent molecule
that can form a cross-linked network, which merges with the natural tear film to form
a protective layer to cover the damaged epithelial cells on the surface of the cornea. This allows
the damaged epithelial cells to be able to repair themselves in a protective space. In
addition to that, Systane complete contains mineral oil which targets the lipid layer
of the tear film to prolong the effectiveness of the eyedrop by reducing evaporation of
the eyedrop and the aqueous layer of the tear film. This helps to retain moisture on the
surface of the eye longer. My number two pick for mild to moderate dry
eye disease is refresh relieva made by Allergan. It contains active ingredients of carboxymethylcellulose
sodium or CMC as well as glycerin. Both of the ingredients are water-soluble polymers
that have characteristics similar to natural tears , and therefore they can lubricate the
surface of the eye with minimal disruption of the natural tears . And glycerin can decrease
the osmolarity of the tear film on the surface of the eye to provide additional lubrication
and promote epithelial cell growth. Among the inactive ingredients, it contains sodium
hyaluronate, it helps repair corneal epithelial cells and lower the tear film osmolarity.
The preservative used in refresh relieva is the purite oxidative preservative. Another
reason I like refresh relieva is that it comes in both preservative containing and preservative
free forms. One of the unique things about refresh relieva is that its preservative free
version comes in a multidose 10 mL bottle, and this packaging wastes a lot fewer drops,
and uses much less plastic packaging material comparing to the single use vial packaging.
It saves money and it's convenient. My favorite over the counter dry eye drop
for mild to moderate dry eye disease is refresh digital artificial tears made by Allergan.
The difference between refresh digital versus refresh relieva is the added emollient component
in refresh digital artificial tears. refresh digital artificial tears contain castor oil
which is a natural ingredient derived from castor beans. And it targets the lipid layer
of the tear film by reducing evaporation of the tear film and extending the effectiveness
of the artificial tears. Besides CMC and glycerin, an additional active ingredient in refresh
digital is polysorbate . Polysorbate can help blend the oil component and the water-solyuble
component of the artificial tears, to make the eye drop more solyuble and easily spread
across the surface of the eye. the preservative used in refresh digital is the purite oxidative
preservative. I do wish the refresh digital preservative free was also available in the
multidose bottle to reduce waste. In moderate to severe dry eye disease, people
often need to use artificial tears very frequently throughout the day, due to the severity of
the surface dryness. sometimes as often as every hour to every two hours , it’s very
important for people with moderate to severe dry eye disease to use preservative free artificial
tears, to prevent any toxicity from such frequent application of the preservatives onto the
surface of the eye. One of my two favorite of over-the-counter eyedrops that can be used
daily is refresh celluvisc. It is preservative free and contains the active ingredient of
1% CMC. This is double the concentration of the CMC contained in other types of refresh
eyedrops. the increased concentration of CMC will allow the artificial tears to stay much
longer on the surface of the eye. However because of the higher concentration of CMC,
Celluvisc is a fairly thick eyedrop, and I often remind my patients who are using it,
that because the eyedrop is very thick you may experience blurry vision for couple of
minutes after putting it in, make sure you blink a few times after putting in the drop,
and don't put in the drop right before driving or operating other machinery.
My other favorite dry eye drop for moderate to severe dry eye disease is GenTeal eye gel
made by Alcon. GenTeal gel is the thickest eyedrop among my top five favorite artificial
tears. It comes in a gel consistency and contains hypromellose 0.3%. hypromellose is short for
hydroxypropyl methylcellulose or HPMC. It is an active ingredient to increase the viscosity
of the eyedrop, to extend the lubricating quality of the eyedrop. HPMC can cross link
when contacting the surface of the eye to slow down tear film evaporation. GenTeal gel
provides long lasting lubrication to the surface of the eye. because of its long lasting lubricating
quality, I typically recommend my patients with severe dry eye disease to use gentle
gel four times a day including at night before going to bed. And also because it’s in a
gel form, it causes less blurry vision than most over the counter eye ointments. It is
important to remember GenTeal gel can still cause some blurry vision shortly after putting
in the eyedrop, So it is important not to put in the drop right before driving or operating
other machinery. And the preservative used in GenTeal gel is sodium perborate, brand
name Genaqua. It’s an oxidative type of preservative.
I have listed in the description down BELOW links to my top five favorite artificial tears
that I mentioned in this video. Thank you for watching and I hope you find
this video helpful in learning more about the science behind artificial tears, and that
this video will help you pick the artificial tears that work best for you. Please let me
know which over-the-counter artificial tears are your favorite in the comments below.
If you find this video helpful please don't forget to like and share this video, and subscribe
to my channel to help me bring you more videos about eye health and eye surgery.
To learn more about my practice you can follow me on Facebook and LinkedIn @DRAudreyTai.
Thank you again for watching and I will see you in the next video.