Thursday, December 2, 2010

Tear Osmolarity Part IV: Prescription Medicines

Sometimes an over the counter (OTC) medicine just isn't enough. Even if your artificial tear was chosen based on advanced testing like the TEAR OSMOLARITY test from Tearlab, it's still possible that you will not have enough relief from your symptoms. This is the time for prescription medicines for your dry eye.

Let's use a couple of simple, straight-forward examples of how our Skyvision Centers doctors use tear osmolarity in the process of choosing a medical treatment for dry eye. If you have symptoms from your dry eye syndrome that are making you uncomfortable, and artificial tears are not enough, there are two very good prescription eye drops to help: RESTASIS and AZASITE*.

Classic dry eye involves a low production of your own, natural tears. This is most often accompanied by an increase in your tear osmolarity. If you have dry eye, a decreased amount of tears (with or without evaporation), and a tear osmolarity ABOVE 308, we have found that Restasis is the first medicine to prescribe.

When your tears don't work well enough you have early evaporation of the tears from the surface of your eye. We call this the "Dysfunctional Tear Syndrome". It can be caused by several things, but observations made by Dr. Darrell White has led us to the conclusion that evaporation along with a tear osmolarity UNDER 300 responds best to an initial treatment with Azasite*.

The really neat use of TEAR OSMOLARITY is when you have low tear volume AND fast evaporation! If the "saltiness" test is below 300 or above 308 we can choose the initial treatment with confidence.

This strategy was first proposed by Dr. White and will be the subject of several academic publications in the near future.

*The use of Azasite for dry eye is a permitted "off-label" application.

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