Ask the Pharmacist
by Ron & Marla Chapleau

February 29, 2016


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Q)  My eyes are dry all the time. I have tried numerous artificial tear drops and gels and they either fail to relieve my symptoms or I have to use them almost constantly to stop the irritation and burning. Is there anything else out there?

A) Dry eyes is an exceptionally common problem at any point during the calendar year, but it is particularly troublesome during the winter months owing to the relative dryness of our air. It is estimated that one out of three adults over the age of 50 struggle with this to some degree or another.

Symptoms are many and vary from person to person but include the feeling of frequently having sand or grit in your eyes, blurred vision, ironically an excessive and a sudden onset of tears, stinging, burning or scratchy sensation in your eyes, eye redness, stringy mucus around your eyes, sensitivity to light, eye fatigue and difficulty with wearing contact lenses or with night time driving.

Obviously, there are other potential causes for any of these symptoms, but if you are struggling with any of these for a period of time, a quick trip to your local optometrist can help define what the actual cause might be.

Dry eyes can be a result of decreased tear production, increased tear evaporation or a change in the actual makeup of your tears (a tear is a complex mixture of water, fatty oils and mucus in specific concentrations).

Decreased tear production can be a result of aging, the after effects of eye surgery (although this is usually only a temporary phenomenon), tear gland damage from inflammation or radiation, certain medications (allergy pills, antidepressants, high blood pressure drugs, cough/ cold remedies, birth control and many others) and a number of medical conditions including but not limited to diabetes, lupus, rheumatoid arthritis and thyroid disorders.

Increased tear evaporation can be a result of environmental factors such as wind, smoke or dry air, blinking less often (which occurs when your concentrating such as driving or reading or problems related to your eyelids (such as in-turning or out-turning of them).

An imbalance in your tear composition can be a result of a number of skin disorders such as rosacea or blepharitis. For many people, the numerous artificial tear drops and gels do a fantastic job of alleviating their symptoms. But, as our original question implied, there are some who continue to struggle with these symptoms.

For some, the prescription eye drop Restasis might be an answer. Restasis (cyclosporine) is a drug that suppresses your immune system and in doing so can decrease the inflammation in the lacrimal glands of the lids. For those people who do not produce enough tears due to inflammation, this drop can be a real game changer.

For people whose dry eyes are caused by other factors, Restasis is likely to be an expensive flop. It comes in single use vials and is instilled as 1 drop twice a day. Like many treatments, Restasis is not a cure. You have to keep administering it in order to keep benefitting from it. Positive effects take a while to achieve as they are often not felt until 3 to 4 weeks after starting therapy and you may not achieve maximal relief until after you have been using them for 3-4 months.

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For those who are unwilling to wait for Restasis to kick in, sometimes a steroid eye drop will be initially prescribed as well to provide some quick relief. Possible side effects include temporary burning or stinging after administration (this should be of a very short duration and is common with most prescription eye drops), eye redness, discharge, eye pain, itching, foreign body sensation and blurred vision.

 In general, Restasis is considered very safe and the vast majority of its side effects are minor in nature or disappear with continued use. Restasis can be used with artificial tears, although the hope is that the tears would be required far less often once the Restasis starts to work. It should be separated by at least 15 minutes from the time of administration of other eye drops including artificial tears. One of the major downsides to this drug is its price. It costs approximately $250 a month and is not covered by the seniors drug plan. Many private insurance plans do however pay for it.

In short, due to its price, delay in taking effect and uncertainty as to whether it will work it is not what I would suggest as a first option in treating dry eyes, but for the many who switch from one artificial tear to another without much relief, this prescription drug may greatly improve the quality of your life.


For more information about this or any other health related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination in Kincardine and Port Elgin Pharmasave.

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