Specialized moisture retention eyewear for evaporative dry eye.

OBJECTIVES: To evaluate the suitablity of commercially available moisture retention eyewear for treating evaporative dry eye. METHODS: Eleven patients with evaporative dry eyes were prescibed moisture retention eyewear for 3 months in addition to regular lubricant eye drops. Frequency and severity of dry eye symptoms, corneal fluorescein staining and tear break up time (TBUT) were evaluated at baseline and 3-month post-treatment. Main outcome measure was global symptom score (based on severity and frequency of dry eye symptoms on a visual analog scale) and secondary outcomes were changes in sectoral corneal fluorescein staining and tear break up time (TBUT) from pre-treatment level. RESULTS: There was a significant improvement in dry eye symptoms after using moisture retention eyewear for 3 months (p < 0.05). Corneal fluorescein staining in all five zones of the cornea in both eyes improved significantly (p < 0.05). There was no significant improvement in TBUT. Patients used ocular lubricants less frequently (p < 0.05) compared to the commencement of the study. Patients found moisture retention eyewear to be useful in relieving dry eye symptoms in windy, air-conditioned environments or when doing vision-related daily tasks. CONCLUSIONS: This study shows that moisture retention eyewear might be a valuable adjunct in management of evaporative dry eye and this new design of commercially available eyewear could have a good acceptability rate.

Lubricant with gelling agent in treating dry eye in adult Chinese patients.

PURPOSE: To investigate the efficacy of a lubricant eye drop containing gelling agent in adult Chinese dry eye patients. METHODS: This is a prospective, randomized, double-masked, double-arm, parallel, interventional single-site clinical study. Thirty Chinese dry eye patients were randomized into two arms, 15 patients each, receiving lubricant eye drops either containing hydroxypropyl-guar (HP-guar) gelling agent (Systane Ultra) or no gelling agent (Refresh Tears), 1 drop, four times a day for 6 weeks. The main outcome measure was global symptom score (based on severity and frequency of dry eye symptoms on a visual analog scale) at weeks 1, 3, and 6. Secondary outcomes were changes in sectoral corneal fluorescein staining, tear break-up time, and Schirmer's I test results from pretreatment level. RESULTS: Both groups showed significant improvement in symptoms from baseline (p < 0.001). There was no significant difference in the global symptom score at weeks 1, 3, and 6 between the two groups. There was significantly more severe corneal fluorescein staining in the HP-guar group at baseline in the left nasal (p = 0.023) and left inferior (p = 0.046) zones, but no difference in staining was observed between the two arms at weeks 1, 3, and 6. There were no differences in Schirmer's test results or tear break-up time (final and pretreatment) between the two groups (p > 0.05). CONCLUSIONS: Both lubricant eye drops, with or without HP-guar gelling agent, benefit patients in relieving dry eye symptoms. There was no difference in the efficacy of these drugs in terms of improving symptoms and altering objective signs of dry eye.

Cost of dry eye treatment in an Asian clinic setting.

OBJECTIVES: To estimate the cost and patterns of expenditure of dry eye treatment. METHODOLOGY: We retrieved data on the type and cost of dry eye treatment in Singapore National Eye Centre from pharmacy and clinic inventory databases over a 2 year period (2008-2009) retrospectively. According to the type of treatment, data were sorted into 7 groups; meibomien gland disease (MGD) treatment, preservative free lubricant eye drops, preserved lubricant eye drops, lubricant ointments and gels, cyclosporine eye drops, oral supplements and non-pharmacological treatments/procedures. Each recorded entry was considered as one patient episode (PE). Comparisons in each group between two years were carried out using Pearson Chi-Square test. Significance level was set at alpha  =  0.05. RESULTS: Cost data from 54,052 patients were available for analysis. Total number of recorded PEs was 132,758. Total annual expenditure on dry eye treatment for year 2008 and 2009 were US$1,509,372.20 and US$1,520,797.80 respectively. Total expenditure per PE in year 2008 and 2009 were US$22.11 and US$23.59 respectively. From 2008 to 2009, there was a 0.8% increase in total annual expenditure and 6.69% increase in expenditure per PE. Pharmacological treatment attributes to 99.2% of the total expenditure with lubricants accounting for 79.3% of the total pharmacological treatment expenditure. Total number of units purchased in preservative free lubricants, cyclosporine eye drops and MGD therapy have increased significantly (p<0.001) whereas number of units purchased in preserved lubricants and ointments/gels have reduced significantly (p<0.001) from 2008 to 2009. CONCLUSION: Dry eye imposes a significant direct burden to health care expenditure even without considering indirect costs. Health care planners should be aware that these direct costs appear to increase over the time and more so for particular types of medications. Given the limitations of socio-economic data, true societal costs of Dry eye syndrome are likely to be much higher than estimated.