Abstract
At the air-water interface, the tear film lipid layer (TFLL), a combination of lipids and proteins plays an important role in surface tension of the tear and is necessary for the physiological hydration of the ocular surface and maintenance of ocular homeostasis. Alteration in lacrimal fluid rheology, differences in lipid constitution or down regulation of particular tear proteins are found in maximum types of ocular surface disease including dry eye disease (DED). Dry eye is a disorder of the tear film due to tear deficiency or excessive tear evaporation, which causes damage to the interpalpebral ocular surface and is associated with symptoms of discomfort. It results in changes on the ocular surface epithelia causing reduced tear quantity and surface sensitivity which leads to inflammation reactions. Managing this inflammation is very helpful in dry eye disease patients. In this article we revise the current understanding of tear film properties, ocular surface and review the effectiveness of topically applied tear supplements, thermo sensitive atelocollagen punctal plug, subtrasal ultrasonic transducers, novel liposome based gelling tear formation and insulin based ophthalmic delivery systems which help in restoring the healthy tear film.
Highlights
Dry eye syndrome is a multifactorial disease affecting lacrimal gland and ocular surface causing discomfort, blurring of vision, instability of the tear film and with latent destruction of the ocular surface
Dry eye disease is categorized into aqueous-deficient and evaporative dry eye disease
Diquafosol ophthalmic solution (3% w/v) on topical instillation show positive action towards both type of dry eye disease-aqueous tear deficient dry eye (ADDE) and evaporative dry eye (EDE)
Summary
Dry eye syndrome is a multifactorial disease affecting lacrimal gland and ocular surface causing discomfort, blurring of vision, instability of the tear film and with latent destruction of the ocular surface. A study was done to compare the efficacy of preservative free 0.1% HA, 0.18% HA and 0.3% HA artificial tear drops in the mouse model withering stress induced environmental and pharmacological experiment in dry eye disease It displayed better protection of corneal epithelial cells compared to HPMC and CMC [23] and better lubricant property by retaining moisture and acted as reservoirs in slowly releasing water molecules [24]. The hyperthermia therapy conducted for obstructive meibomian gland dysfunction is by liquefying the keratinized meibum present in meibomian gland elevating the temperature of glands by 5 °C to 7 °C (41 °C to 43 °C) This leads to secretion of meibum with increased stability and it avoids to evaporation of the tear from the ocular surface. Even though the diffusion of heat occurs by itself, more studies are required to know the spatial distribution of heat [43]
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