Do artificial tears prevent ocular damage?

From the Guidelines

Liquid tears play a crucial role in preventing eye damage by lubricating the eye, washing away foreign particles, and containing antimicrobial components that help fight infections. Tears form a protective film over the eye's surface, consisting of three layers: an oily outer layer that prevents evaporation, a watery middle layer that provides moisture and nutrients, and a mucin inner layer that helps tears adhere to the eye surface 1. Without adequate tears, the eye becomes dry and vulnerable to irritation, inflammation, and potential damage to the cornea. Dry eyes can lead to corneal abrasions, increased risk of infection, and in severe cases, corneal ulcers or vision impairment.

For people with dry eye syndrome, artificial tears (lubricating eye drops) available over-the-counter can help supplement natural tear production. These should be used as directed, typically 1-2 drops in each affected eye 4-6 times daily. Preservative-free formulations are recommended for frequent use to avoid irritation from preservatives 1. More severe cases may require prescription medications or procedures to conserve natural tears or increase tear production.

Some key considerations for the use of liquid tears include:

• Patient education on the importance of complete blinking and blinking frequency, especially when using visual display terminals 1
• Environmental considerations, such as avoiding excess dryness caused by wind or dry environments, and using humidifiers to maintain a healthy moisture level 1
• Dietary modifications, including a Mediterranean-diet-oriented approach, and potentially supplementing with essential fatty acids or omega-3 fatty acids 1
• Avoiding the use of certain cosmetics and cautioning against the independent purchase of over-the-counter eye drops that may contain preservatives or vasoconstricting agents 1

Overall, liquid tears are a vital component of eye health, and their use can help prevent eye damage and promote overall ocular well-being. The most recent and highest quality study recommends the use of preservative-free artificial tears for frequent use 1.

From the Research

Liquid Tears and Eye Damage Prevention

• Liquid tears play a crucial role in protecting and lubricating the ocular surface, and their composition and function are essential for maintaining eye health 2.
• The tear film consists of an aqueous-mucin layer and a lipid layer, which work together to provide a stable, well-lubricated, and smooth optical surface 2.
• Tear factors also promote wound healing, suppress inflammation, scavenge free radicals, and defend against microbial infection, highlighting their importance in preventing eye damage 2.

Omega-3 Fatty Acids and Dry Eye Syndrome

• Omega-3 fatty acid supplements have been shown to improve tear film characteristics, reverse ocular surface features, and alleviate subjective symptoms associated with dry eye syndrome in patients with type 2 diabetes 3.
• A meta-analysis of randomized controlled studies found that omega-3 fatty acid supplementation was associated with better tear break-up time and Schirmer's test results, suggesting its effectiveness in managing dry eye syndrome 4.
• Another study found that long-chain omega-3 supplementation may have a possible role in managing dry eye disease, although the evidence is uncertain and inconsistent 5.

Effectiveness of Omega-3 Fatty Acids in Relieving Dry Eye Symptoms

• A randomized controlled study found that omega-3 fatty acid supplements were effective in relieving dry eye symptoms and signs in symptomatic visual display terminal users 6.
• The study also found that the omega-3 index, a measure of EPA and DHA ratio in RBC membrane, was a predictor of potential dry eye patients who are likely to benefit from oral omega-3 dietary intervention 6.
• Overall, the evidence suggests that omega-3 fatty acids may be beneficial in preventing eye damage and relieving dry eye symptoms, although further research is needed to confirm their effectiveness 4, 5, 3, 6.