A. ARTIFICIAL TEARS, VISCOELASTICS, AND LUBRICATING OINTMENTS
82
Notes: 1) Viscosity of water is 0.7 centistokes*
2)centistokes (cs) X density = centipoits (cp)
3)centipoits seconds = cps
4)Boric acid is a balanced salt solution used to equalize osmolarity
Preservatives Legend: |
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N = None |
1 |
= Purite |
2 |
= EDTA |
3 |
= Benzalkonium chloride |
4 |
= Chlorobutanol |
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5 = Polyquad |
6 |
= Sorbic acid |
7 |
= Sodium |
8 |
=Methyl propylparbens |
9 |
= Polyhexamethylene |
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perborate |
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biguanide |
10=polixetonium |
N/A = Not |
11 = chlorite |
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available |
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Low Viscosity
Low viscosity lubricants are useful in mildly symptomatic dry eyes; they have a low tendency to blur vision but typically do not last as very long.
Trade Name |
Viscosity |
Osmolarity |
Preservative |
Preservative Free |
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Bion Tears |
5–15 cps*** / 4.5 cs* |
270–330 |
N |
Dry Therapy |
0.7 cs* |
N/A |
N |
Hypotears PF |
<5 cps++ / 1.2 cs* / 2.8 cp** |
220 |
N |
Oasis Tears |
30 cp |
275 |
N |
Preservative Free Advanced Eye Relief |
< 5 cps # |
270–330 |
N |
Refresh, Optive Sensitive |
5 cp** / 2.8 cs* |
250–305 |
N |
Refresh Plus |
3 cp** / 2.0 cs* |
270–340 |
N |
Systane (preservative free) |
7–15 cps |
270–330 |
N |
Systane Ultra Unit Dose |
9–15 cps |
Tears Naturale Free |
5–15 cp*** / 4.3 cs* |
Preserved |
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AKWA Tears |
3.5 cp |
Blink Tears |
11 cp |
Computer Eye Drops |
< 5 cps# |
FreshKote |
22.5 cps |
GenTeal |
7 cps++ / 3.6 cs* |
Hypotears |
<5 cps++ / 1.2 cs* / 2.8 cp** |
Isopto Plain |
15–30 cps*** |
Isopto Tears |
15–30 cps*** |
Liquifilm Tears |
4 cp** |
Advanced Eye Relief |
< 5 cps# |
Murine |
2.3 cpy |
Optive |
20 cps |
Puralube Tears |
5 cpyy |
Refresh Tears |
3.0 cp** |
Soothe |
2.0–2.2 cpsA |
Systane |
7–15 cps## |
Systane Ultra |
8–15 cps |
Tearisol |
10–30 cp++ |
Tears Naturale |
5–15 cp*** / 3.7 cs* / 7.0 cp** |
Tears Naturale II |
6–12 cp*** / 4.0 cs* |
Tears Plus |
4 cp** / 2.8 cs* |
Tears Renewed |
2–10 cps## |
Tears Naturale like no longer available, just Tears Natural Tears II and Tear Naturale Forte
265–290 |
N |
270–330 |
N |
250–310 |
2, 3 |
175 |
11 |
270–330 |
3 |
288–291 |
10 |
220 |
7 |
220 |
2, 3 |
270–330 |
3 |
270–330 |
3 |
220–270 |
4 |
270–330 |
3 |
260 |
2, 3 |
330 |
1 |
N/A |
2, 3 |
280 |
1 |
240–289 |
9 |
270–330 |
5 |
270–300 |
5 |
220 |
2, 3 |
270–330 |
3 |
270–330 |
5 |
260–310 |
4 |
265–325 |
3 |
Lubricants and Viscoelastics 83
High Viscosity |
84 |
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High viscosity lubricants are useful in severely symptomatic dry eyes; they have a tendency to blur vision but last longer than low viscosity products. If symptoms are not controlled by artifical tears, consider temporary or permanent punctal occlusion therapy; tarsorraphy may be considered for severe cases of exposure keratopathy.
Trade Name |
Viscosity |
Osmolarity |
Preservative |
Preservative Free |
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Aquasite PF |
250–750 cps++ / 800 cp** |
235 |
N |
Celluvisc |
170 cs* / 200–300 cp** |
270–350 |
N |
Oasis Tears Plus |
>100 cp |
300 |
N |
Ocucoat PF |
46 cs* |
285 32 |
N |
Refresh Endura |
150 cps |
220–300 |
N |
Preserved |
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Aquasite |
250–750 cps++ / 800 cp** |
235 |
2 |
Blink Gel Tears |
50 cp |
175 |
11 |
Ocucoat |
46 cs* |
285 32 |
3 |
Ultra Tears |
100–300 cps*** |
270–330 |
3 |
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Unknown Viscosity |
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Trade Name |
Viscosity |
Osmolarity |
Preservative |
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Comfort Tears |
N/A |
N/A |
2, 3 |
Dry Eyes Lubricant Eye Drops |
N/A |
N/A |
3 |
Dwelle |
N/A |
N/A |
10 |
Murocel |
N/A |
N/A |
8 |
Ocu-Tears PF |
N/A |
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N |
Theratears |
N/A |
170 |
N |
Visine Tears |
N/A |
270–320 |
3 |
Visine Pure Tears Portables |
N/A |
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N |
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Insert
Drug |
Trade Name |
Preparation |
Usual Dose |
Notes |
hydroxypropyl cellulose |
Lacrisert |
Insert, 5 mg |
QD-BID |
for moderate to severe dry eye syndrome |
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Gels & Ointments |
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Ointments |
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Trade Name |
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Note: Some individuals may be allergic to lanolin |
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AKWA Tears Ointment |
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Lanolin containing |
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Dry Eyes |
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not available |
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Dry Eyes Lubricant Ointment |
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Lanolin containing |
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Duolube |
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Lanolin free |
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Duratears Naturale |
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Lanolin containing |
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Hypotears |
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Lanolin free |
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Lacri-Gel |
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Lanolin containing |
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Lacri-Lube S.O.P |
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Lanolin containing |
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Lubefree Petrolatum, Mineral Oil Lubricant |
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Lanolin free |
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LubriTears Lubricant Eye Ointment |
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Lanolin containing |
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Moisture Eyes PM |
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Lanolin free |
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Ocu-Lube |
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Lanolin containing |
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Puralube |
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Lanolin free |
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Refresh P.M. |
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Lanolin containing |
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Systane Nightime Ointment |
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Lanolin containing |
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Tears Renewed Ointment |
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Lanolin free |
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Lubricants and Viscoelastics 85