How to choose the best moisturizing eye drops? List of the most effective drugs

The category of moisturizing ophthalmic preparations is a special type of eye drops that do not perform therapeutic functions. They serve to relieve symptoms of fatigue and partially restore the natural tear film , and also provide the organs of vision with protection from external factors.

There are many such products that may differ in composition and principle of action.
Note! And despite the fact that they are available without a prescription and usually do not have serious contraindications, it is recommended to consult an ophthalmologist before choosing them.

How moisturizing eye drops work

Moisturizing ophthalmic solutions perform several functions at once, including:

• moisturizing the cornea;
• thickening of the protective mucin (tear) layer;
• increasing the viscosity characteristics of tear fluid;
• formation and restoration of the tear film.

Many drugs are identical in composition or close to natural tear fluid, so they not only do not cause discomfort, but also do not affect the refraction of light.
Indirectly, such drugs can even serve as a prophylactic against cataracts, glaucoma and less serious diseases, as they have keratoprotective (protective) properties, neutralizing the impact of negative external factors on the visual organs.

How a lack of hyaluronic acid leads to skin aging -

Almost all of the skin's hyaluronic acid is located in its dermal layer (Fig. 2) - exactly where the collagen and elastin fibers responsible for skin elasticity are located. Loss of moisture (dehydration) from this layer of skin leads to the following effects:

• Slow collagen degeneration - a decrease in the amount of hyaluronic acid leads to a decrease in water content in the dermis, which leads to weak hydration of collagen and elastin fibers with water. Under these conditions, slow degeneration of collagen fibers occurs with a gradual decrease in its quantity. In addition, all other collagen loses the proper degree of plasticity (ability to shrink/decompress). And this affects the elasticity of the skin.

• Reduced skin thickness – dehydration of the dermal layer of the skin leads to a decrease in its thickness, accordingly, the skin becomes thinner and less elastic. Thin skin is more prone to the early appearance of wrinkles.

• Reduced activity of fibroblasts and keratinocytes - fibroblasts are responsible for the synthesis of collagen and elastin. When there is a lack of hyaluronic acid, their activity decreases, which affects their collagen production. The activity of keratinocytes, on which the thickness of the epidermal layer of the skin depends, also decreases. A decrease in the thickness of the epidermis leads to a decrease in the protective properties of the skin and to greater evaporation of water from its surface.

Hyaluronic acid for the face: reviews from cosmetologists... thus, the additional supply of hyaluronic acid (with a decrease in its content in the dermis) helps ensure that the dermis is saturated with moisture and the collagen remains sufficiently hydrated with water. Plus, the activity of fibroblasts and keratinocytes increases, stimulates angiogenesis, cell regeneration, and metabolic processes. All this keeps the skin well hydrated, elastic and, accordingly, prevents the development of wrinkles.

Types of moisturizing solutions

It is worth noting! All moisturizing eye drops can be divided into three large groups:

1. Exclusively moisturizing preparations . Their main purpose is to moisturize the conjunctiva and cornea when diagnosed with dry eye syndrome.
2. Vitamin and mineral drops . They are closest in composition to natural tear fluid, but in addition to moisturizing and protecting the eyes, they also nourish the tissues of the eyeball with the microelements necessary for normal functioning. Often used by people who constantly work at the computer.
3. Products for those who have to wear contact lenses. In this category of people, while using contact optics, dry eye syndrome often develops and tissue repair processes may even be disrupted. Moisturizing solutions help prevent this.

In some cases, drugs from different groups can be combined, although most often just some drops are sufficient.

Moisturizing drops for adults

For adult patients, the following eye moisturizers can be recommended:

1. Cationorm. Developed in Japan and currently a unique cationic emulsion for moisturizing the eyes, it restores all three layers of the tear film, permanently eliminating severe, intense discomfort and dry eyes that appear throughout the day, even in the morning. The emulsion prevents the further development of dry eye syndrome and does not contain preservatives; it can be used in conjunction with contact lenses. Prescribed to people with severe complaints of dryness and eye discomfort; people who wear contact lenses constantly and more than 10 hours a day; people with eye diseases such as glaucoma, blepharitis, allergic conjunctivitis; people undergoing hormone replacement therapy (menopausal hormones, oral contraceptives).
2. Oftagel. The best eye gel with carbomer in maximum concentration. Helps with watery eyes, fatigue, itching and burning eyes. The gel can be used once a day, for example, before bedtime; it is perfect for those who do not want or cannot use drops during the day.
3. Visine. Despite the fact that side effects often occur when using this drug, Visine remains the most popular drug due to its availability. The drug eliminates the feeling of dryness and “sand” in the eyes, and you do not need a prescription from a specialist to purchase it. It is recommended to instill the drug no more than three times a day at equal intervals, one or two drops in each eye. But if the medicine is prescribed by an ophthalmologist, you must adhere to the regimen prescribed by him.
4. Visomitin. An almost complete analogue of Vizine, which is prescribed in case of side effects when using Vizine. Sometimes this medicine is used as an additional remedy in the treatment of cataracts and conjunctivitis of various origins. The solution is instilled three times a day, one drop at a time.
5. Systane ultra. A remedy to relieve symptoms of fatigue, irritation and dry eyes. The medicine contains not only moisturizing substances, but also vitamins that strengthen the tissue of the eyeball. There are no strict restrictions in terms of the number of instillations of this product - it can be instilled throughout the day as the feeling of eye fatigue increases, a couple of drops at a time.
6. Natural tear . A synthetic drug that is a complete analogue of tear fluid. It can be used not only for adults, but also for children, although in the second case a preliminary consultation with an ophthalmologist is recommended. Approximately every two to three hours, one drop is instilled into each eye.
7. Inoxa. The drug not only moisturizes and protects the conjunctiva, but also has a weak antihistamine effect, so it is sometimes prescribed for the complex treatment of eye allergies. If used solely for moisturizing, instill inox as needed. In all other cases, consultation with a doctor is required.

Premium Review

LIBREDERM hyaluronic cream with a broad spectrum of action , intended for the eyes, price about 700 rubles, used for any skin type, without fragrances and parabens used for preservation. Tightens, brightens and eliminates swelling.

Estee Lauder Advanced Time Zone made in France, containing hyaluronic acid in various forms. The average price is 3000 rubles. Effectively fights wrinkles on the eyelids, has a moisturizing effect, without fragrances.

Vichy Aqualia Thermal eye cream, the price of which for 15 g is 800 rubles. The composition includes hyaluronic acid and thermal water, which serves to moisturize. The consistency is close to that of a gel, and for ease of application the tube is equipped with a metal roller. Eliminates swelling and does not contain fat.

Drops for children

Note! For children, if eye hydration is necessary, it is better to use the following medications:

1. Tobrex. This is a combination drug, one of the functions of which is to moisturize and strengthen the mucous membrane. For such purposes, it is enough to instill the product up to three times a day, one drop at a time.
2. Oksial. They act as anti-inflammatory and moisturizing drops, which additionally have a restorative effect on the tissue cells of the cornea. Depending on how severe the dry eye syndrome is, drops are used one to three times a day.
3. Hilo chest of drawers. The solution is often used for problems with eye hydration resulting from the use of contact optics. It is recommended to instill drops at least three times a day, one drop in each eye.

"Blefarogel 1"

This domestic product is widely used for cosmetic and therapeutic care of the skin of the eyelids. It can be used in the treatment of chronic blepharitis and stye to relieve inflammation, irritation, and eliminate dry eyes. Also, “Blepharogel 1” can be prescribed for preventive purposes in case of high visual loads, eye fatigue, and impaired tear secretion production in users of contact optics. It moisturizes the skin of the eyelids well, helps eliminate signs of dry eye syndrome, and relieve discomfort that occurs when working at a computer or wearing contact lenses.

The drug has a moisturizing, anti-inflammatory, antiseptic and tonic effect due to its constituent components. Hyaluronic acid maintains an optimal level of moisture in the skin of the eyelids and is responsible for its elasticity and softness. It also has a positive effect on the functioning of the eye glands and improves their secretion. Aloe vera extract acts as an antiseptic, fights inflammation, and tones the skin. Glycerin has a softening and moisturizing effect, forms a protective layer that prevents moisture evaporation.

If you use lenses, then before applying the gel to the skin around the eyes, contact lenses must be removed.

Eye drops with hyaluronic acid

Important! Hyaluronic acid is a compound that helps strengthen and restore corneal tissue. Solutions containing such a substance are characterized by increased keratoprotective characteristics.

Among these drugs you can choose the following:

1. Okutiars. These are proven and frequently prescribed ultra-high molecular weight hyaluronic acid eye drops without preservatives. They moisturize well, eliminate dryness and eye discomfort that occurs periodically after prolonged visual work (for office workers, students, drivers, etc.). Once opened, the bottle is stored for 6 months and since it does not contain preservatives, it can be dropped onto contact lenses. Ocutiarz is often used to relieve discomfort after ophthalmological operations on the cornea, such as PRK, LASIK, cataract extraction.
2. Stillavit . A drug for moisturizing the conjunctiva and protecting it from external factors and irritants: dust, bacteria, foreign bodies. The product promotes the formation of a stronger protective film on the surface of the eyeball and its uniform distribution over the surface of the eye. Drops can be instilled 3-6 times a day.
3. Vizmed . Drops to replenish the deficiency of tear fluid and restore the tear film. The drug does not contain preservatives and can be used even when wearing contact lenses (the optics do not need to be removed during instillation).

Hyaluronic acid: application in ophthalmology and treatment of dry eye syndrome

This review describes the use of GA in the anterior segment of the eye, in particular in the treatment of dry eye syndrome, as well as in contact lenses and lens care systems. Key words: hyaluronic acid, dry eye syndrome, contact lenses. Abstract Hyaluronic acid: it's usage in ophthalmology and in treatment of dry eye syndrome EA Egorov

RNIMU named after NI Pirogov Department of Ophthalmology named after acad. AP Nesterov This review describes the effectiveness of Hyaluronic acid in the treatment of dry eye syndrome and its usage in contact lens and solutions for contact lenses. Key words: hyaluronic acid, dry eye syndrome, contact lenses.

Hyaluronic acid (HA) is a natural polysaccharide with unique viscoelastic and hygroscopic properties. These characteristics determine the participation of HA in many processes in the human body [1–3]. HA is used in ophthalmological practice: in cataract surgery to optimize the installation of an intraocular lens, in vitreoretinal surgery. HA is included in the material of contact lenses to improve the comfort of wearing them [4]. Dry eye syndrome In recent decades, the importance of the problem of dry eye has increased. This is due to the intensive development of both modern ophthalmic surgery and pharmacotherapy of eye diseases. According to ARVO, in 2012, dry eye syndrome ranked third in the number of published studies, second only to glaucoma and age-related macular degeneration. According to Reddy, the prevalence of the disease reaches 11–17% among the entire population [17]. The quality of life of patients with moderate severity of dry eye syndrome is equal to that of patients with moderate angina pectoris [18]. The largest group is young patients (20–45 years old), in whom dry eye syndrome is associated with excessive evaporation of tear fluid (office syndrome, wearing contact lenses, refractive surgery, transient disorders of tear formation after infectious and inflammatory processes, etc. .) (Fig. 1). In the group of patients over 55 years of age, the disease is caused by endocrine changes leading to impaired tear formation and is called Sjögren's syndrome [19]. The result of tear replacement therapy should be the elimination of discomfort in patients. Drugs for the treatment of dry eye syndrome must have a physiological mechanism of action. These are the characteristics inherent in drugs based on HA. Method of production of HA for use in pharmacotherapy of dry eye syndrome The tolerability of HA-based tear substitutes is largely determined by the production method. Previously, methods were used to obtain HA from the vitreous humor of a cow's eye and the comb of a rooster. The disadvantages of these production methods were their high cost and the presence of protein impurities in the final product, which led to a large number of allergic reactions to the drug [5]. Modern HA production is based on a fermentation process using bacteria (Streptococcus equi and Streptococcus zooepidemicus). HA obtained in this way has a higher degree of purification, which explains the better tolerability of HA by patients [1, 2]. Properties of HA that determine its use for the treatment of dry eye syndrome HA is a natural polymer and belongs to the group of polysaccharides, which are also called connective tissue polysaccharides, mucopolysaccharides or glycosaminoglycans [1, 3, 7]. These polysaccharides influence the distribution of water in connective tissue, incl. and corneal stroma [6, 8]. According to its physicochemical properties, HA can change its structure depending on pH (acidity or alkalinity), salt concentration and the influence of pressure gradient [9]. An increase in the pressure and temperature gradient leads to a decrease in the viscosity of the solution. Similarly, due to the alkaline pH value, a more mobile molecular structure is formed [1, 10]. In addition to its viscoelastic properties, HA has a pronounced ability to retain water. This property may be due to the presence of a large number of hydroxyl groups, which leads to the formation of hydrogen bonds [1, 7, 11–14]. Researchers claim that HA can hold up to 1000 times its own weight in water [7, 24]. Normally in the human body, HA is found in the extracellular matrix of connective tissue in the skin and synovial fluid [1–3]. HA is also detected in the vitreous body, lacrimal gland, corneal epithelium and conjunctiva of the eye [1–3, 15, 16]. It is assumed that HA has anti-inflammatory properties and is involved in cell functioning processes, such as proliferation, differentiation and migration [20]. It has been proven that HA stimulates the migration of epithelial cells, which promotes the healing of corneal wounds [21–23]. Numerous studies have demonstrated the effectiveness of GCs in the symptomatic treatment of dry eye [3, 13, 25–29]. In this case, a balanced concentration of HA in the composition of the tear replacement drug is of great importance. In a controlled, double-blind, crossover study of 20 patients with severe dry eye, 0.1% HA, 0.2% HA, or placebo were administered 6 times daily for 14 days. The purpose of this study was not only to evaluate the effectiveness of GC in severe dry eye, but also to determine the most effective concentration of the drug. There were no significant differences between the 0.1% HA solution and placebo groups in Schirmer test results, tear breakup time (TBR), and rose bengal staining test results. However, when comparing a higher concentration of HA solution - 0.2% with placebo, a significant difference in the results of rose bengal staining was revealed in the group of patients receiving HA (P < 0.005). In this group, a more pronounced increase in VRSP was also observed compared with that with placebo (P < 0.005) [29]. In a comparative, randomized, blinded, placebo-controlled study of 12 patients, BPSP was assessed with 0.05%, 0.1%, or 0.3% HA solution. VRSP measurements were carried out before instillation of eye drops, as well as after 5, 15, 30, 60, 120 and 180 minutes. after her. A significant increase in VRSP was found for HA concentrations of 0.1% and 0.3% [25]. To assess subjective tolerability and HRSP in patients with insufficiency of the lipid component of the tear film, 10 patients were instilled with a 0.18% HA solution in one eye and a 0.3% hydroxypropyl methylcellulose solution in the other. Both treatments resulted in significant increases in VRSP at 15, 30, and 60 min. after instillation compared with baseline (P < 0.05), however, the increase in VRSP in the group receiving GC was significantly higher at 30 and 60 min. observations (P=0.04 and P=0.005, respectively) [28]. Thus, taking into account the results of these studies, a concentration of 0.1–0.3% can be considered a therapeutically significant concentration of HA. Returning to the topic of the prevalence of dry eye syndrome, it should be noted that it occurs in both young people and older people. When prescribing therapy, it is necessary to take into account the nature of the disease in each of these groups. Thus, in a group of young patients with excessive evaporation of tear fluid, the symptoms are predominantly transient. In this group, it is optimal to use a higher concentration of GC (0.2–0.24%) for rapid but short-term relief of symptoms. In international clinical practice, Artelac Splash (Bausch + Lomb, USA), a preservative-free drug containing 0.2 and 0.24% HA, has proven itself to be excellent. The release form of this drug is different - both in a standard bottle and in multidoses. In the older age group (over 55 years) with endocrine-determined disorders of tear secretion, the course of dry eye syndrome is chronic. In this group, we can recommend the use of drugs with a lower concentration of HA - from 0.15% Oxial (Bausch + Lomb, USA). Conclusion HA plays an important role in ocular physiology. The unique physicochemical properties of HA served as the basis for its effective use in the symptomatic treatment of dry eye syndrome. Taking into account the prevalence of this syndrome (both young and elderly patients), recommendations for the use of various concentrations of HA in tear substitutes have been determined. Thus, for faster relief of transient symptoms, the administration of GC in a concentration of 0.2–0.24% Artelac Splash (Bausch + Lomb, USA) is indicated. In the group with chronic dry eye syndrome (age over 55 years), long-term use of drugs with a lower concentration of HA – 0.15% Oxial, (Bausch + Lomb, USA) is possible.

References 1. Lapcik L. Jr., Lapcik L., DeSmedt S. et al. Hyaluronan: preparation, structure, properties and applications // Chem Rev. 1998. Vol. 98. R. 2663–2684. 2. Milas M., Rinaudo M. Characterization and properties of hyaluronic acid (hyaluronan). In: Dumitriu S. ed. Polysaccharides Structural Diversity and Functional Versatility. New York, NY: Marcel Dekker, 2005. pp. 535–549. 3. Stuart JC, Linn JG Dilute sodium hyaluronate (Healon) in the treatment of ocular surface disorders // Ann Ophthalmol. 1985. Vol. 17. R. 190–192. 4. Fonn D. Targeting contact lens induced dryness and discomfort: what properties will make lenses more comfortable // Optom Vis Sci. 2007. Vol. 84. R. 279–285. 5. Andre P. Evaluation of the safety of a non-animal stabilized hyaluronic acid (NASHAdQ-Medical, Sweden) in European countries: retrospective study from 1997 to 2001 // J Eur Acad Dermatol Venereol. 2004. Vol. 18. R. 422–425. 6. Duranti F., Salti G., Bovani B. et al. Injectable hyaluronic acid gel for soft tissue augmentation. A clinical and histological study // Dermatol Surg. 1998. Vol. 24. R. 1317–1325. 7. Hargittai I., Hargittai M. Molecular structure of hyaluronan; an introduction // Struct Chem. 2008. Vol. 19. R. 697–717. 8. Davies A., Gormally J., Wyn-Jones E. et al. A study of hydration of sodium hyaluronate from compressibility and high precision densitometric measurements // Int J Biol Macromol. 1982. Vol. 4. R. 436. 9. Scott JE Extracellular matrix, supramolecular organization and shape // J Anat. 1995. Vol. 187 (Pt 2). R. 259–269. 10. Scott JE, Cummings C, Brass A et al. Secondary and tertiary structures of hyaluron in aqueous solution, investigated by rotary shadowing electron microscopy and computer simulation // Biochem J. 1991. Vol. 274. R. 699–705. 11. Cantor JO, Nadkarni PP Hyaluronan: the Jekyll and Hyde molecule // Inflamm Allergy Drug Targets. 2006. Vol. 5. R. 257–260. 12. Polack FM Healon (Na Hyaluronate): A review of the literature // Cornea. 1986. Vol. 5. R. 81–93. 13. Sindt CW A new dry eye therapy? Could hyaluronic acid be instrumental in the treatment of dry eye? // Rev Cornea Contact Lenses. 2009. Vol. 1. R. 12. 14. Szczotka-Flynn LB Chemical properties of contact lens rewetter // CL Spectrum. 2006. Vol. 21. 15. Lerner L., Schwartz D., Hwang D. et al. Hyaluronan and CD44 in the human cornea and limbal conjunctiva: letter to the editor // Exp Eye Res. 1998. Vol. 67. R. 481–484. 16. Yoshida K., Nitatori Y., Uchiyama Y. Localization of glycosaminoglycans and CD44 in the human lacrimal gland // Arch Histol Cytol. 1996. Vol. 59. R. 505–513. 17. Reddy P. et al. // Cornea. 2004. Vol. 23(8). R. 751–761. 18. Brown MM // Arch Ophthalmol. 2009. Vol. 127(2). R. 146–152. 19. Report of the International Dry Eye WorkShop (DEWS) // Ocul Surf. 2007. Vol. 5 (2). R. 61–204. 20. Presti D., Scott JE Hyaluronan-mediated protective effect against cell damage caused by enzymatically produced hydroxyl (OH.) radicals is dependent on hyaluronan molecular mass // Cell Biochem Funct. 1994. Vol. 12. R. 281–288. 21. Gomes JA, Amankwah R, Powell-Richards A et al. Sodium hyaluronate (hyaluronic acid) promotes migration of human corneal epithelial cells in vitro // Br J Ophthalmol. 2004. Vol. 88. R. 821–825. 22. Inoue M., Katakami C. The effect of hyaluronic acid on corneal epithelial cell proliferation // Invest Ophthalmol Vis Sci. 1993. Vol. 34. R. 2313–2315. 23. Nishida T., Nakamura M., Mishima H. ​​et al. Hyaluronan stimulates corneal epithelial migration // Exp Eye Res. 1991. Vol. 53. R. 753–758. 24. Nakamura M., Hikida M., Nakano T. et al. Characterization of water retentive properties of hyaluronan // Cornea. 1993. Vol. 12. R. 433–446. 25. Hamano T., Horimoto K., Lee M. et al. Sodium hyaluronate eyedrops enhance tear film stability // Jpn J Ophthalmol. 1996. Vol. 40. R. 62–65. 26. Johnson ME, Murphy PJ, Boulton M. Effectiveness of sodium hyaluronate eyedrops in the treatment of dry eye // Graefes Arch Clin Exp Ophthalmol. 2006. Vol. 244. R. 109–112. 27. Miyauchi S., Sugiyama T., Machida A. et al. A 26-week ophthalmic instillation test of sodium hyaluronate in rabbits // Pharmacometrics. 1993. Vol. 46. ​​R. 317–328. 28. Prabhasawat P., Tesavibul N., Kasetsuwan N. Performance profile of sodium hyaluronate in patients with lipid tear deficiency: randomized, double-blind, controlled, exploratory study // Br J Ophthalmol. 2007. Vol. 91. R. 47–50. 29. Sand BB, Marner K., Norn MS Sodium hyaluronate in the treatment of keratoconjunctivitis sicca. A double masked clinical trial // Acta Ophthalmol (Copenh). 1989. Vol. 67. R. 181–183.

List of inexpensive products

Among the inexpensive eye moisturizers, the following are preferred:

1. Hyphenation . The drug forms a strong tear film and does not distort vision, and also has a moisturizing effect. It has the longest contact with the cornea, as it contains the viscous component hypromellose. It is not recommended to use this product without breaks for more than three weeks. Every day you can do no more than eight drops (two drops in each eye).
2. Slesin. One of the most “neutral” drugs that can be used for moisturizing at any age. In addition to dry eye syndrome, the drug is prescribed as a prophylactic solution for lacrimation disorders resulting from ophthalmological diseases or injuries. Depending on the need, it is instilled every 3-5 hours.

Contraindications for use

Among all other categories of ophthalmic drugs, moisturizing drops have the fewest contraindications.

Stay up to date! However, they are not prescribed in cases of individual intolerance to the components of the drugs or in case of hypersensitivity to them.

And also, if you are prone to allergic reactions , some moisturizing solutions can cause a negative reaction in the body, so if you notice the first symptoms of an allergy (itching, irritation and redness of the conjunctiva), you should discard the drops and choose an alternative.

Patient reviews

“When I first
encountered the problem of dry eyes , I experimented for a long time, trying expensive and cheap products. In the end, I decided to settle on a teardrop . This is a natural product that
does not cause for me and allows me to work comfortably at the computer all day . In addition, if necessary, such a product can easily be purchased at any nearby pharmacy, which cannot be said about some expensive and supposedly “more effective” products.”

Anton Leontyev, Volgograd.

“ My daughter is in the eighth grade and due to heavy strain on her eyes during lessons, several months ago she began to get very tired , citing the fact that reading and using the computer cause discomfort.

When visiting an ophthalmologist , it turned out that the girl had dry eye syndrome .