From the Guidelines
For patients with a history of stroke presenting with dry eyes, artificial tears should be used as often as needed for symptom relief, typically starting with 4-6 times per day. According to the dry eye syndrome preferred practice pattern 1, the use of artificial tears may be increased, but the practicality of frequent tear instillation depends on the lifestyle or manual dexterity of the patient. Nonpreserved tear substitutes are generally preferable, especially when used frequently and chronically (e.g., more than four times a day) 1. Some key points to consider when using artificial tears in these patients include:
- Preservative-free formulations are preferred to avoid irritating the ocular surface with repeated use 1
- Thicker lubricating ointments can be applied before bedtime for overnight relief
- Stroke patients may have reduced blink rate or incomplete eyelid closure that contributes to corneal exposure and dryness, making regular lubrication particularly important
- If symptoms persist despite frequent artificial tear use, patients should be evaluated for punctal plugs or other advanced dry eye treatments
- Proper application involves placing one drop in the lower eyelid pocket of each affected eye and gently closing the eyes for 30 seconds to allow distribution across the ocular surface. The literature indicates that artificial tears are safe and an effective modality for treating dry eye 1, and the most artificial tears may have comparable efficacies.
From the FDA Drug Label
Invert the unit dose vial a few times to obtain a uniform, white, opaque emulsion before using. Instill one drop of RESTASIS® ophthalmic emulsion twice a day in each eye approximately 12 hours apart. RESTASIS® can be used concomitantly with artificial tears, allowing a 15 minute interval between products. The frequency of using artificial tears is not specified in the drug label. However, it is mentioned that RESTASIS® can be used concomitantly with artificial tears, allowing a 15 minute interval between products.
- The label does not provide information on how often artificial tears should be used.
- It only provides guidance on the use of RESTASIS® and its compatibility with artificial tears 2.
From the Research
Frequency of Artificial Tears Use
- The frequency of artificial tears use can vary depending on the severity of dry eye disease and the specific formulation of the artificial tears 3.
- A study found that drop frequency ranged from two to up to 16 drops per day, with no major complications or adverse events reported 3.
- Another study compared the efficacy of two new formulations of artificial tears, with patients using the drops at least twice daily, and found that both formulations were effective in reducing dry eye symptoms 4.
- The use of artificial tears in combination with other treatments, such as cyclosporine A, may also be effective in managing dry eye disease 5, 6.
Considerations for Patients with a History of Stroke
- There is limited information available on the specific use of artificial tears in patients with a history of stroke presenting with dry eyes.
- However, the available evidence suggests that artificial tears can be effective in managing dry eye disease, regardless of the underlying cause 3, 4, 7, 5, 6.
- Patients with a history of stroke may need to use artificial tears more frequently, depending on the severity of their dry eye disease and other individual factors.
Recommended Use
- The recommended frequency of artificial tears use can vary depending on the specific formulation and the individual patient's needs.
- Patients should follow the instructions provided by their healthcare provider or the manufacturer's recommendations for the use of artificial tears 3, 4.
- In general, artificial tears can be used as needed, but patients may need to use them more frequently in certain situations, such as in dry or windy environments, or when experiencing increased dry eye symptoms 3, 4.