Artificial tears provide one of a number of measures that are used to treat tear deficiency. Other measures include occlusion of the lacrimal puncta or the use of mucolytic agents. The first step is to make the diagnosis. Once a deficiency of tears has been confirmed, the mainstay of treatment is hypromellose. Adsorptive polymers of acrylic acid can also give symptomatic relief. Polyvinyl alcohol is another compound present in a number of tear substitutes. Recently, a new agent, sodium hyaluronate (0.1%) has been shown to improve symptom relief and improve the ocular surface abnormalities in cases of severe dry eye. By their nature, tear substitutes tend to adhere to the surface of the eye and in the conjunctival sac. For this reason, their prolonged use is liable to give rise to preservative reactions. Preservative-free preparations are often preferable. Some patients with a severe dry eye problem might need to instill the drops every hour or even more frequently.
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