This document discusses wetting agents, tear substitutes, and other treatments for dry eyes. It describes how wetting agents work by reducing surface tension and strengthening adhesive properties. Tear substitutes are isotonic or hypotonic solutions that contain electrolytes, surfactants, preservatives, and viscosity agents to prolong the tear film. Viscosity agents include cellulose polymers, polyvinyl alcohol, polyethylene glycol, and mineral oil. Some tear formulations are combined with vasoconstrictors. Ointments used contain white petrolatum, mineral oil, and lanolin. Highly viscous formulations can cause vision blurring and are used for severe dry eyes or at bedtime. Hydroxypropyl cellulose inserts are

1. WETTING AGENTS &TEAR
SUBSTITUTES
DR.A.PRATHEEP KUMAR
POST GRADUATE
INSTITUTE OF PHARMACOLOGY
MADRAS MEDICAL COLLEGE

4. WETTING AGENTS
Substance reduce the surface tension of water to allow it to spread
drops onto a surface
Weakening Cohesive properties of the liquid and strengthen adhesive
property

5. TEAR SUBSTITUTES
The current management of dry eyes usually artificial tear
Tear substitutes are isotonic or hypotonic composed of
1)electrolytes
2) surfactants
3)preservatives
4) viscosity agents that prolongs the resistance time in the cul-de-
sac and precorneal tear flim

9. VISCOSITY AGENTS
1) CELLULOSE POLYMERS
2) POLYVINYL ALCOHOL
3) POLYETHYLENE GLYCOL
4) MINERAL OIL
5) GLYCERIN AND DEXTRAN

10. Some tear formulation are combined with vasoconstrictor such as
naphazoline ,phenylephrine
ointments
composed of
1) white petrolatum ,
2) mineral oil,
3) liquid or alcohol lanolin
4) sometimes a preservative

11. • Highly viscous formulations cause considerable blurring of vision they
are used primarily at bed time in critically ill patients or in very severe
dry eye conditions
• Ophthalmic insert
• A hydroxy propyl cellulose –ophthalmic insert placed in the inferior
cul de sac and dissolves during the day is available to treat dry eyes
such as blepharitis ,ocular rosacea ,chemical burns , corneal dystrophy

15. Ophthalmic cyclosporin
it is used to increase tear production in patient with ocular
inflammation with keratoconjunctivitis sicca
osmotic drugs
osmotic ocular drugs are glycerine
mannitol
hypertonic saline

16. • Glycerine and mannitol are used for short term management of IOP
• These agents are used intraoperatively to dehydrate the vitreous prior to
anterior segment surgical procedure
• Many of the patients do not tolerate oral medications in acute glaucoma
therefore i.v mannitol or acetazolamide

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