THERAPEUTIC FOCUS

PROVIDE LONG-LASTING LUBRICATION

MID-VISCOSITY ARTIFICIAL TEAR BINDS TO CORNEA AND REPLACES SALT

MILTON M. HOM, O.D., F.A.A.O.

AN INVENTOR of artificial tears reminded me of the Goldilocks principle: too hot, too cold or “juuuuuuust right.” Tears are commonly classified according to viscosities: low, moderate and high. Patients usually fall in love with a particular viscosity.

Here I discuss Refresh Optive Gel Drops, a mid-viscosity eye lubricant that some patients consider “juuuuuuust right.”

OVERVIEW

Refresh Optive Gel Drops (ROGD) contain carboxymethyl cellulose (CMC) and compatible solutes. CMC is a mucoadhesive polymer, which adheres to the corneal surface and, thus, allows for longer duration of benefit from the drop.

Compatible solutes, such as glycerin, can take the place of salt, which scientists theorize corneal cells uptake from the tears because of osmotic imbalance, which leads to dehydration. When the cornea cells uptake compatible solutes instead of salt, however, they are protected from osmotic damage. ROGD contains the same compatible solutes found in other Refresh lubricants.

PROCEDURE

In my experience, patients love particular types of tears. Once they find that special viscosity, or combination of viscosity, they are reluctant to change.

For those dry eye patients who are not happy with their present artificial tear, I suggest ROGD. For example, begin the conversation by saying: “There is a new product that may provide you with longer lasting relief throughout the day.”

For patients who have not yet had experience with artificial tears, I will ask several questions to determine whether they are a good candidate for the drops and their willingness to adhere to the treatment plan.

I start by asking the patient how often he or she experiences dryness. Depending on the answer, I educate the patient on his or her options, which include over-the-counter (OTC) or prescribed medication. If the OTC drop is appropriate, I recommend ROGD.

PRACTICE BENEFITS

ROGD is another option within an O.D. toolbox to find the most compatible option for each patient. It combines artificial tear technologies: CMC, compatible solute and mid-viscosity. For some patients, like Goldilocks, it will be juuuuust right. OM

DR. HOM is a private practitioner in Azusa, Calif. He has written numerous articles and several books on a broad range of topics, including dry eye, contact lenses, multimedia and imaging. Visit tinyurl.com/OMcomment to comment.