Review-making dry eyes wet
•Download as PPT, PDF•
26 likes•5,043 views
Title: Making dry eyes wet Author: Dr. Zia ul Mazhry FRCS (Edin), FRCS (Glasgow), FCPS, CICOphth (UK) PURPOSE: to review current management options to treat dry eyes especially evaluation of Genteal gel and Systane eye drops as novel new combinations. clinical outcome. RESULTS: both the agents showed higher satisfaction and better clinical outcomes as compared to other available wetting agents. CONCLUSION: Genteal eye gel and Syatane eye drops are excellent recent additions to available options to treat dry eyes symptomatically. Genteal family appears to be better tolerated as compared to Systane E/D in our experience. Dr. Zia ul Mazhry FRCS (Edin), FRCS (Glasgow), FCPS, CICOphth (UK) Consultant Eye Surgeon and Head of Eye Department Wapda hospital complex 210 Feroz Pur Road Lahore 0300 440 1151
![Making Dry Eyes Wet ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Making Dry Eyes Wet](https://image.slidesharecdn.com/sialkot-makingdryeyeswet-101015002420-phpapp02/85/Review-making-dry-eyes-wet-1-320.jpg)
![How to put the audience to sleep? Making Dry Eyes Wet z z z z z z %age of audience dosing off Time (minutes) 0 10 20 30 40 50 60 ,[object Object],[object Object],[object Object],[object Object],10 20 30 60 0](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
More Related Content
What's hot
What's hot (20)
Viewers also liked
Viewers also liked (20)
Similar to Review-making dry eyes wet
Similar to Review-making dry eyes wet (20)
More from Central Park Medical College and WAPDA Teaching Hospital Lahore
More from Central Park Medical College and WAPDA Teaching Hospital Lahore (18)
Recently uploaded
Recently uploaded (20)
Review-making dry eyes wet
- 6. Definition Making Dry Eyes Wet
- 8. Etiological Classification Making Dry Eyes Wet
- 13. Dry Eye does affect quality of life Making Dry Eyes Wet
- 16. Dry Eye Diagnosis Making Dry Eyes Wet Test cutoff value for dry eye diagnosis ● Schirmer's I less than or equal to 5 mm wetting over 5 minutes ● Tear Breakup time less than or equal to 10seconds ● Tear Meniscus height less than or equal to 0.2 mm ● Fluorescein staining more than 3 out of 15 ● Rose Bengal staining more than 3 out of 18 ● Tear film osmolarity more than 316 mOsm/L ● Impression cytology more than 1 ● Brush cytology more than 1 ● Tear lactoferrin less than or equal to 0.9 ug/mL
- 19. Dry eye questionare Making Dry Eyes Wet
- 21. comprehensive “dry eye assessment” can include: Making Dry Eyes Wet
- 28. Normal healthy tears Making Dry Eyes Wet Normal Healthy Tears
- 31. Is Ideal tear substitute currently available? NO Making Dry Eyes Wet
- 32. A tear drop
- 34. A Tear Drop Composition Making Dry Eyes Wet
- 35. Drug Components Making Dry Eyes Wet Systane Polyethylene Glycol 400 0.4% (lubricant), Propylene Glycol 0.3% (lubricant), Hydroxypropyl Guar (GEL FORMING MATRIX) Polyquaternium-1 as preservative. Genteal Gel 0.3% Hydroxypropyl Methylcellulose, Carbopol 980 GenAqua (Sodium Perborate) as preservative .
- 40. Choosing the right brand for the right patient Making Dry Eyes Wet
- 44. GenTealGel is non blurring 1 Kessler C. Spektrum Augenheilkd 1991; 5:69-75 Unlike ointments, GenTeal gel is a crystal clear and colorless liquid gel that will not blur patient’s vision 1 The difference is clear GenTeal Gel Ointment
- 47. GenTeal gel has a long retention time Carbomer (in GenTeal gel) lasts 7 times longer in the eye compared with conventional artificial tears 1 1 Marquardt R, et al. Klin Monatsbl Augenheilkd 1986; 189:254-257 16.5 minutes 2.3 minutes 15.9 minutes 2.03 minutes Carbomer Conventional tear substitute Carbomer Conventional tear substitute LEFT EYE RIGHT EYE
- 48. GenTeal gel needs fewer applications 1 Bron AJ, et al. Eur J Ophthalmol 1998; 8:81-89 Carbomer (in GenTeal gel) requires significantly fewer applications 1 Mean number of drops per day Day of the study 5 4.5 4 3.5 3 2.5 2 0 4 8 12 16 20 24 28 32 36 40 2 6 10 14 18 22 26 30 34 38 P<0.05 Conventional tear substitute Carbomer gel
- 50. Do the disappearing preservatives really disappear? Making Dry Eyes Wet
- 54. To Summarize: Making Dry Eyes Wet
- 57. Keep blinking Making Dry Eyes Wet
- 58. How to put the audience to sleep? Making Dry Eyes Wet z z z z z z %age of audience dosing off Time (minutes) 0 10 20 30 40 50 60 10 20 30 60 0
- 59. Thank you
Editor's Notes
- The normal tear film contains lipid, aqueous, and mucin components. The outer lipid layer protects against evaporation. (It contains a much greater variety of lipids than is shown in this drawing.) Tear lipids are secreted by meibomian glands with orifices at the lid margins. The aqueous component is thought to form a gel with soluble mucins that decreases in density toward the lipid layer. It includes a complex mixture of proteins, mucins, and electrolytes. Both the water component and nearly all of the tear proteins are secreted by the main and accessory lacrimal glands. Mucins are a crucial component: they provide viscosity Stabilize the tear film against the shear force exerted by each blink cycle Transmembrane mucins anchored in epithelial cells provide a transition between the hydrophobic cell surface and the hydrophilic aqueous component Soluble mucins are secreted by goblet cells of the conjunctival epithelium
- What are the consequences of the changes in tear composition that are associated with chronic dry eye? The ocular surface environment changed from the normal trophic environment that supports normal growth and function. Increased osmolarity is known to affect the growth and function of many cells. The lack of growth factors and imbalance in cytokines means that normal epithelial growth is poorly supported. Poor viscosity can result in thin spots in the tear film – and tear break-up. Lubrication that is necessary for ocular comfort during the blink cycle is compromised, and irregularities in the tear film may contribute to the blurred vision experienced by many CDE patients. Changes in tear composition contribute to the ocular surface damage found in chronic dry eye patients. Proteolytic degradation of tight junctions between corneal epithelial cells results in loss of corneal barrier function (often visualized with fluorescein staining). Squamous metaplasia of the conjunctival epithelium is associated with a markedly reduced population of mucin-secreting goblet cells. Membrane-bound mucins are decreased in chronic dry eye as well. Tears bathe all ocular surface tissues – it is not surprising that altered tear composition would have profound impacts on their growth and function.
- Contrast the graphic of healthy tears on the previous slide with tears in chronic dry eye shown here. The concentrations of many tear proteins, including those with antimicrobial functions, are reduced. Growth factor concentrations are reduced as well. The soluble mucin 5AC is greatly reduced in concentration, because of the profound loss of goblet cells from the conjunctival epithelium that is typical of chronic dry eye. This impacts the viscosity of the tear film. Protease that are present in healthy tears in a latent inactivated form, are now activated. They can degrade the extracellular matrix and the tight junctions between adjacent cells of the corneal epithelium. Activated proteases are also responsible for cleavage of many cytokines into an activated pro-inflammatory form. The increase in electrolyte concentrations means that the osmolarity of the tear film is increased in chronic dry eye.
- This slide contrasts the complexity of the mixture of proteins, mucins and other factors found in normal healthy tears, with artificial tears. Artificial tears contain electrolytes, which are balanced to mimic the osmolarity and pH of normal tears, but they lack the important biological properties provided by the proteins and mucins that are present in normal healthy tears.