Clinical observation of esculin and digitalisglycosides eye drops with 0.3% sodium hyaluronate eye drops for dry eye disease: a randomized controlled trial

To evaluate the clinical efficiency of the treatment of dry eye disease (DED) with ocular pain using deproteinized calf blood extract (DCBE) eye drops as compared to 0.3% sodium hyaluronate (SH) eye drops. This prospective, single-center, masked (double-blind), randomized controlled study included 53 patients divided into two groups: DCBE (n=22) and SH (n=31) group. The DCBE group received DCBE eye drops for 4 weeks, and the SH group received 0.3% SH eye drops for 4 weeks. Corneal fluorescein staining (CFS) scores, tear break up time (TBUT), Schirmer test and the ocular surface disease index (OSDI) scores were evaluated in all patients before treatment, 2 and 4 weeks post-treatment. The DCBE group showed better improvement in the OSDI light sensitivity scores and ocular pain scores compared with the SH group (P<0.05). At 2 and 4 weeks post-treatment, the DCBE group and the SH group showed significant improvement in TBUT, Schirmer test, CFS, OSDI score, light sensitivity score and ocular pain score (P<0.05) compared with the data from before treatment. This study indicates that DCBE eye drops can relieve ocular pain and light sensitivity in dry eye patients better than SH eye drops.

Objective To observe the efficiency and safety of 0.1% sodium hyaluronate(SH)eye drops and basic fibroblast growth factor(bFGF) eye drops in simplex dry eye and dry eye after LASIK. Design Randomized controlled study. Participants 70 cases with simplex dry eye(group Ⅰ) and 40 post-LASIK cases(group Ⅱ) from January 2012 to August 2012. Method There were two subgroups in group Ⅰ and group Ⅱ respectively. 0.1% SH(A) and bFGF(B) eye drops were used randomly, four times a day for 14 days in group Ⅰ and 30 days in group Ⅱ. Changes of symptoms and signs were observed at different times. Dry eye symptoms including asthenopia, foreign body sensation, eye dry, burning sensation, swelling sensation, ophthalmodynia, conjunctiva congestion and photophobia were scored using questionnaire survey. Main Outcome Measures Score of dry eye symptoms, tear break-up time(BUT), Schirmer TestⅠ,corneal fluorescein staining(FL), symptoms changes of self-evaluation. Results Ocular symptoms and signs improved significantly after treatment in both subgroups of group Ⅰ(P0.05). 0.1% SH eye drops was better than bFGF eye drops in improving asthenopia(P=0.006) and ophthalmodynia(P=0.040) at 14 days after treatment(P0.05). SH was better to improve BUT(P=0.055) and Schirmer TestⅠ(P=0.573),and bFGF was better to reduce corneal fluorescein staining(P=0.375), but the different was not significant. Significant change of symptoms in patients using SH eye drops and bFGF eye drops were 94.3% and 78.6%, respectively. In group Ⅱ, there were symptoms in 1and 3 days after LASIK, and improved in 10 and 30 days post-operation. SH eye drops was better than bFGF eye drops in improving foreign body sensation(P=0.004), burning sensation(P0.001), swelling sensation(P=0.005) and conjunctiva congestion(P=0.007). BUT and Schirmer TestⅠ decreased in 10 days after LASIK, but increased in 30 days, than that of 10 days after operation(groupⅡA BUT:P=0.142, Schirmer TestⅠ: P=0.053; groupⅡB BUT: P=0.006, Schirmer TestⅠ: P=0.010). Corneal fluorescein staining aggravated in 10 day after LASIK, and improved in 30 days, with significant differences(groupⅡA P=0.005, groupⅡB P=0.079). There was no significant difference between groupⅡA and groupⅡB in changes of dry eye signs. No side-effect was found during observation. Conclusion SH and bFGF eye drops can facilitate corneal epithelial repair, improve tear film stability, and alleviate various symptoms in simplex dry eye and post-LASIK patients. SH eye drops is better than bFGF eye drops in improving certain symptoms including asthenopia, foreign body sensation, burning sensation, swelling sensation, conjunctiva congestion and ophthalmodynia.

The aim of this study was to evaluate the efficacy of hypotonic 0.18% sodium hyaluronate (SH) eye drops under the clinical settings of the dry eye workshop treatment guideline for mild dry eye disease (DED). This analysis included 60 patients with DED. Patients with level 1 DED were treated with either isotonic 0.1% SH (group 1) or with hypotonic 0.18% SH eye drops (group 2). Patients with level 2 DED were treated with 0.1% fluorometholone, 0.05% cyclosporine A, and either isotonic 0.1% SH (group 3) or hypotonic 0.18% SH (group 4) eye drops. Tear film breakup time (TBUT), Schirmer test, corneal staining with fluorescein, and ocular surface disease index score were recorded at baseline, 1 month, and 3 months after treatment. In group 2, TBUT at 3 months (P = 0.03) and corneal staining scores at 1 and 3 months (P ≤ 0.03) were significantly improved after the treatment compared with baseline scores, whereas these parameters were not changed during the follow-up period in group 1. In groups 3 and 4, TBUT and corneal staining scores at 1 and 3 months, and ocular surface disease index score and Schirmer test results at 3 months after the treatment showed significant improvements compared with the baseline score (P < 0.05). Group 4 patients showed an extended TBUT and an improved corneal staining score (P ≤ 0.01) at 3 months after treatment, compared with the values of group 3. Hypotonic 0.18% SH eye drops seemed to be effective in improving tear film stability and ocular surface integrity compared with isotonic 0.1% SH eye drops in patients with mild DED.

Understanding the Dual Dilemma of Dry Eye and Glaucoma: An International Review.

Purpose: The efficacy of using preservative-free 0.15% sodium hyaluronate eyedrops for dry eye disease after femtosecond laser- assisted cataract surgery (FLACS) was evaluated. Methods: This prospective randomized study was conducted on patients with dry eye who were scheduled for FLACS among those with Tear Film &amp; Ocular Surface Society Dry Eye Workshop II Dry Eye Levels 1 and 2. In total, 37 eyes scheduled for FLACS were randomized to the treatment group (n = 19) or control group (n = 18). Corneal and conjunctival fluorescein staining (CFS), tear breakup time (TBUT), Schirmer I test (SIT) value, ocular surface disease index (OSDI), meibomian gland evaluation result, and lipid layer thickness were evaluated for all patients, preoperatively and at 1 and 3 months postoperatively. Results: In the treatment group, the OSDI and CFS scores were significantly lower at 3 months postoperatively than at baseline, but the TBUT and SIT values were significantly increased. In the control group, TBUT was significantly shorter at 3 months postoperatively than at baseline, SIT values were significantly decreased at 1 and 3 months postoperatively compared with the baseline, and meibum quality was significantly aggravated at 1 month postoperatively compared with the baseline. In the treatment group, OSDI improved significantly from baseline at 1 and 3 months. TBUT increased significantly in the treatment group at postoperative 3 months. Meibomian gland quality showed clinically better results in the treatment group than in the control group at postoperative 3 months. There were no significant differences in corneal and CFS, lipid layer thickness, and other dry eye disease parameters between the treatment and control groups. Conclusions: Preservative-free 0.15% sodium hyaluronate eyedrops were effective for improving dry eye symptoms and tear film stability after FLACS.

Dry Eye Disease (DED) is a chronic and multifactorial condition that significantly impacts patient quality of life. Topical ophthalmic drugs (TODs) have emerged as key treatments for DED, offering the potential to address the underlying pathology rather than merely alleviating symptoms. This review aims to assess the efficacy of various TODs in managing the symptoms of DED. A comprehensive search was conducted across three electronic databases to identify relevant articles for inclusion in this review. Two independent authors screened the articles according to predefined eligibility criteria. A total of 16 randomized controlled trials (RCTs) were included, summarizing data from 2,680 patients. The data were analyzed using Review Manager 5.4, with pooled analysis conducted on key symptoms including corneal fluorescein staining (CFS), Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), and Schirmer test scores. From 632 articles identified, 16 RCTs were selected for inclusion. The pooled analysis revealed that cyclosporine therapy resulted in a significant improvement in CFS scores (mean difference (MD) -0.24; 95% confidence interval (CI) (-0.42, -0.07), P = 0.006). However, no significant improvements were observed in OSDI, TBUT, or Schirmer test scores (MD -0.35; 95% CI (-5.66, 4.96), P = 0.9; MD 0.12; 95% CI (-0.65, 0.89), P = 0.76; MD -0.22; 95% CI (-0.46, 0.02), P = 0.07, respectively). Similar results were found for loteprednol etabonate (LE) and diquafosol sodium, with no significant changes in OSDI, CFS, or Schirmer test scores. For diquafosol, no significant improvements were observed in any of the DED symptoms, including OSDI (MD -3.82; 95% CI (-8.31, 0.67), P = 0.10), CFS (MD -0.31; 95% CI (-0.82, 0.20), P = 0.23), TBUT (MD -0.20; 95% CI (-1.37, 0.98), P = 0.74), and Schirmer test (MD -1.00; 95% CI (-2.60, 0.60), P = 0.22). The study concluded that cyclosporine therapy offers improvements in corneal fluorescein staining but does not significantly affect other common DED symptoms, such as OSDI, TBUT, and Schirmer test scores. Similarly, no significant improvements in DED symptoms were observed with loteprednol etabonate or diquafosol sodium. Further research is needed to explore the efficacy of these treatments in managing DED symptoms more comprehensively.

To compare the clinical efficacy between penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops and sodium hyaluronate eye drops alone for the treatment of dry eye. A total of 156 patients (312 eyes) with dry eye were randomly assigned to an observation group and a control group, with 78 patients (156 eyes) in each group. The control group was treated with sodium hyaluronate eye drops, one drop per eye, four times daily, for 4 weeks. In addition to the sodium hyaluronate treatment, the observation group received penetrating needling of three eye acupoints. Acupoints included bilateral Cuanzhu (BL2), Sizhukong (TE23), Sibai (ST2), and Jingming (BL1). Needling was performed once daily, four times a week, for 4 weeks. The subjective ocular symptom scores, neuropathic pain symptom inventory-eye (NPSI-Eye) scores, ocular surface disease index (OSDI) scores, corneal fluorescein staining (FL) scores, tear break-up time (BUT), SchirmerⅠtest (SⅠT), central tear meniscus height (TMH), and tear levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were evaluated before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. After treatment, both groups showed significant improvements in subjective ocular symptom scores, NPSI-Eye scores, OSDI scores, FL scores, and reductions in tear IL-6 and TNF-α levels (P<0.01). Additionally, BUT, SⅠT, and TMH were increased significantly in both groups (P<0.01). After treatment, the subjective ocular symptom scores, NPSI-Eye score, OSDI score, FL score, and tear levels of IL-6 and TNF-α in the observation group were lower than those in the control group (P<0.01, P<0.05), while BUT, SⅠT, and TMH were significantly improved compared to the control group (P<0.01). The markedly effective rate and total effective rate in the observation group were 83.3% (65/78) and 100.0% (78/78), respectively, which were higher than 52.6% (41/78, P<0.01) and 92.3% (72/78, P<0.05) in the control group. The penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops can effectively alleviate symptoms of dry eye, reduce inflammatory response, and has superior efficacy to sodium hyaluronate eye drops alone.

ABSTRACTPurpose: To evaluate corneal parameters of patients with ankylosing spondylitis (AS) by Scheimpflug imaging and also to clarify the associations between disease severity and clinical status of AS and corneal parameters. Methods: Fifty-seven patients with AS and 57 healthy subjects were included in this cross-sectional study. All participants underwent a detailed ophthalmological evaluation. Corneal parameters were measured by Pentacam. In addition, Schirmer test, tear break-up time (TBUT), corneal fluorescein staining, and Ocular Surface Disease Index (OSDI) scores were evaluated. Duration of disease and scores of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Quality of Life scale (ASQoL) of the patients were recorded. The laboratory evaluation consisted of human leukocyte antigen (HLA)-B27, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results: Corneal parameters were significantly different between patients with AS and healthy controls. The mean central corneal thickness (538 ± 26 µm versus 569 ± 27 µm, p < 0.001) and the mean corneal volume (59.8 ± 3.33 mm3 versus 62.3 ± 3.40 mm3, p < 0.001) were reduced significantly in AS patients compared to those in healthy controls. The values of TBUT and Schirmer test scores were significantly lower in AS patients than in controls. Also, corneal fluorescein staining and OSDI scores were higher in AS patients than in controls. Factors related to the corneal parameters were dry eye tests (TBUT, Schirmer test, corneal fluorescein staining), OSDI score, and CRP (p < 0.05 for all). Conclusion: The AS patients have thinner corneas compared to control subjects, which may be affected by tear disfunction and inflammatory processes.

Highlight: Computer vision syndrome (CVS) that causes dry eyes becomes a health problem for college students. Sodium hyaluronate eyedrops can be used as one of the CVS therapy strategies for students suffering from CVS. Abstract: The use of computers and mobile devices is increasing. Computers and mobile devices help our daily work or study. However, prolonged use of them may cause computer vision syndrome (CVS). Nowadays, CVS becomes a health problem for everyone working with computers or mobile devices including college students because it causes dry eyes. It may disrupt reading, doing professional work, or using a computer which is important for college students to complete academic tasks. Sodium hyaluronate can be used to overcome the dry eye problem due to CVS. To assess the effectiveness of sodium hyaluronate eyedrops on students suffering from CVS, pre- and post-administration of sodium hyaluronate was measured for two weeks. Inclusion criteria for this study were college students aged 20-35 years, using a computer for &gt;2 hours a day, not using nonsteroidal anti-inflammatory drugs (NSAIDs), not consuming drugs, or having a disease that affects tear production and bearing no pregnancy. Parameters assessed include tear break-up time using the Tear Break-Up Time (TBUT) test, tear production using the Schirmer I test, the number of clinically subjective symptoms, and Ocular Surface Disease Index (OSDI) scores. Data were analyzed using student paired t-tests or Wilcoxon Rank Test. There were statistically significant differences before and after the TBUT (4.4 vs 6.7 seconds; p&lt;0.0001); the Schirmer I Test (4 vs 6 mm; p&lt;0.05), and the number of clinically subjective symptoms (3 vs 0 clinically subjective symptoms; p&lt;0.0001). The OSDI scores did not show statistical differences before and after administration of sodium hyaluronate (27 vs 21; p&gt;0.05), but there was a positive impact from moderate to mild dry eye. Sodium hyaluronate eyedrops can be used as one of the CVS therapy strategies for students suffering from CVS.

Background: Dry eye disease (DED) is a multifactorial condition with a globally rising prevalence. Diagnosis relies on both symptoms and clinical tests, but these methods demonstrate variability. Strip meniscometry (SMTube) represents a rapid, non-invasive alternative method, but its diagnostic value remains uncertain. We evaluated the correlation of its findings with those of established DED evaluations. Methods: In this cross-sectional study, we recruited 100 individuals with and without DED (n = 50 each) who visited a tertiary ophthalmology clinic. Diagnosis of DED was based on symptomatology and standard criteria, including a tear break-up time (TBUT) &lt; 5 s or Schirmer test I result &lt; 5 mm, along with an Ocular Surface Disease Index (OSDI) score &gt; 12 and corneal fluorescein staining grade &gt; 1. The exclusion criteria included ocular surgery, allergy, or contact lens use. All participants underwent comprehensive ophthalmic examination and standardized DED assessments (OSDI, tear meniscus height [TMH], SMTube, TBUT, corneal fluorescein staining, and Schirmer test I), conducted in a controlled setting by a single examiner during 9–11 AM to ensure consistency. Results: The DED group was significantly older (P &lt; 0.05). No significant sex difference was observed between groups (P &gt; 0.05). The OSDI, TMH, SMTube, TBUT, corneal fluorescein staining, and Schirmer test I findings differed significantly (all P &lt; 0.001), while SMTube application discomfort rates were similar between groups (P &gt; 0.05). In the DED group, SMTube correlated moderately with TBUT (r = + 0.41, P &lt; 0.05) and OSDI (r = + 0.43, P &lt; 0.05), while the Schirmer test I correlated weakly with TBUT (r = + 0.34, P &lt; 0.05) and moderately with TMH (r = + 0.52, P &lt; 0.05). In the controls, no significant correlations were observed between tear metrics and SMTube or Schirmer test I findings (all P &gt; 0.05), except for corneal fluorescein staining, which showed a weak negative correlation with SMTube (r = - 0.28, P &lt; 0.05) and a moderate positive correlation with Schirmer test I findings (r = + 0.51, P &lt; 0.05). Conclusions: SMTube findings differed significantly between the DED and control groups and correlated moderately with those of established diagnostic assessments, particularly the TBUT and OSDI. Unlike Schirmer testing, SMTube results are closely associated with symptom severity, suggesting its utility in reflecting patient-reported discomfort. Given its simplicity, non-invasiveness, and correlation with key clinical indicators, SMTube may serve as a valuable adjunct in the multimodal assessment of DED. However, further studies are needed to establish its diagnostic accuracy and to confirm its clinical utility.

To describe dry eye disease in French elderly subjects. The Alienor Study is a population-based study on age-related eye disease in 963 residents of Bordeaux (France), aged 73 years or more. Self-reported dry eye disease and use of artificial tears were documented through face-to-face interview. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire and tear film stability by tear break-up time measurements (TBUT). Definite dry eye disease was defined as self-reported dry eye, confirmed by use of artificial tears and/or OSDI greater or equal to 22. Nine hundred and fifteen subjects, with mean age of 80 ± 4 years, returned the OSDI questionnaire. Of these, 271 (29.6%) subjects reported a dry eye disease and 135 (14.7%) were using artificial tears. An OSDI score > 22 was found in 359 (39.2%) subjects and a TBUT < 5 seconds in 335/746 (44.9%) subjects. Overall, definite dry eye affected 21.9% of subjects and was more frequent in women (27.1%) than in men (13.6%). After multivariate adjustment, dry eye disease was also significantly less frequent in subjects with high educational level (odds ratio (OR) = 0.49, 95% confidence interval (CI): 0.31-0.78 for long secondary school) and more frequent in subjects with ocular hypertension (OR = 1.61, 95% CI: 1.02-2.57) and those using anxiolytics (OR = 1.53, 95% CI: 1.02-2.29). This large observational study confirmed the high prevalence of dry eye symptoms among elderly subjects and confirmed some of the previously identified risk factors (in particular female gender and use of anxiolytics).

BackgroundThe management of post-refractive surgery dry eye disease (DED) can be challenging in clinical practice, and patients usually show an incomplete response to traditional artificial tears, especially when it is complicated with ocular pain. Therefore, we aim to investigate the efficacy of combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment in post-refractive surgery DED patients with ocular pain unresponsive to traditional artificial tears.MethodsWe enrolled 30 patients with post-refractive surgery DED with ocular pain who were unresponsive to traditional artificial tears. Topical 0.05% cyclosporine A and 0.1% sodium hyaluronate were used for 3 months. They were evaluated at baseline and 1 and 3 months for dry eye and ocular pain symptoms and objective parameters, including Numerical Rating Scale (NRS), Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-Eye), tear break-up time (TBUT), Schirmer I test (SIt), corneal fluorescein staining (CFS), corneal sensitivity, and corneal nerve morphology. In addition, tear levels of inflammatory cytokines and neuropeptides were measured using the Luminex assay.ResultsAfter 3 months of treatment, patients showed a statistically significant improvement in the ocular surface disease index (OSDI), TBUT, SIt, CFS, and corneal sensitivity (all P < 0.01) using linear mixed models. As for ocular pain parameters, the NRS and NPSI-Eye scores were significantly reduced (both P < 0.05) and positively correlated with the OSDI and CFS scores. Additionally, tear IL-1β, IL-6, and TNF-α levels were improved better than pre-treatment (P = 0.01, 0.03, 0.02, respectively).ConclusionIn patients with post-refractive surgery DED with ocular pain, combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment improved tear film stability, dry eye discomfort, and ocular pain, effectively controlling ocular inflammation.Trial registrationRegistration number: NCT06043908.

This study evaluates the efficacy and safety of autologous serum eye drops (ASEDs) combined with sodium hyaluronate in treating dry eye disease (DED) after phacoemulsification cataract surgery. This retrospective cohort study included patients diagnosed with DED within 1 week to 1 month after cataract surgery at our hospital (August 2022-July 2023). Patients were divided into a combined group (ASEDs + sodium hyaluronate, n = 48) and a monotherapy group (sodium hyaluronate only, n = 63). Propensity score matching was used to balance baseline characteristics, resulting in 48 patients in each group. Both groups were treated for at least 4 weeks. Clinical indicators, including Ocular Surface Disease Index (OSDI), Schirmer I test (SIT), tear breakup time (BUT), fluorescein staining, conjunctival hyperemia, and conjunctival impression cytology, were assessed before and after treatment. After propensity score matching, baseline characteristics were comparable (P > .05). The mean age was 43.83 ± 8.84 years in the combined group and 43.93 ± 8.84 years in the monotherapy group (P = .865), with male proportions of 47.9% and 45.8%, respectively (P = .779). Other variables, including body mass index, disease duration, OSDI, SIT, and BUT, also showed no significant differences. After 4 weeks, the combined group showed significantly greater improvements. OSDI scores decreased to 14.09 ± 4.22 versus 21.50 ± 4.82 (P < .001); SIT increased to 10.23 ± 2.00 mm versus 8.50 ± 1.50 mm (P < .001); BUT extended to 8.18 ± 0.96 seconds versus 6.00 ± 1.00 seconds (P < .001). Fluorescein staining scores reduced to 0.56 ± 0.22 versus 1.86 ± 0.76 (P < .001), with conjunctival hyperemia and conjunctival impression cytology scores also significantly improved in the combined group (P < .001). ASEDs combined with sodium hyaluronate significantly improve both symptoms and ocular surface parameters in post-cataract DED patients, showing superior efficacy over monotherapy and promising clinical value.

Purpose: To investigate the efficacy and adverse effect of cyclosporine combined with sodiumhyaluronate (SH) eye drops on dry eye syndrome (DES).Methods: 148 patients with DES treated in Nanjing Drum Tower Hospital Group Suqian Hospital,Jiangsu Province, China between January 2022 and February 2023 were randomly assigned to control(70 cases) and study groups (78 cases). Control group was treated with SH eye drop (1 drop each onboth eyes 5 - 6 times a day, for 2 months), while study group was treated with both SH (the samedosage and use with control group) and cyclosporine eye drop (1 - 2 drops each for both eyes, 4 - 6times a day, for two months). Tear film stability indices such as schirmer I test (SIT), tear break-up time(BUT) and corneal fluorescein stain (FL) of both groups were analyzed before and after therapy.Results: There was no significant difference in BUT, SIT and FL score between the two groups beforetreatment. Compared with before treatment, BUT and SIT increased significantly (p &lt; 0.05), while FLscore dropped significantly in both groups after treatment (p &lt; 0.05). After treatment, study groupshowed significantly higher BUT and SIT levels, and significantly lower FL score than control group (p &lt;0.05).Conclusion: The combination of cyclosporine eye drops with SH eye drops is effective in treating DES.This combination regimen protects tear film stability, effectively alleviates DES symptoms, improvesocular surface and meibomian gland function, and also increases lacrimal river height, withoutincreasing adverse reactions. Further studies will be required, to provide more evidence for clinicalapplication of this combination regimen.

Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer's test, and impression cytology of conjunctiva from baseline. An observational study was carried out during a 2-year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8-week period. Ocular surface disease index, tear film breakup time, and Schirmer's test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Significant improvement in patient symptoms, tear film breakup time, and Schirmer's test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t-test showed comparable results. Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.