When the tear film is disrupted, the epithelial cells on the surface of the cornea are exposed and begin to die (cell apoptosis). The body responds with inflammatory cytokines and matrix metalloproteinases (MMPs). If the tear film deficiency is continued, the epithelial layer of the cornea is compromised, and the damage becomes chronic. MMPs are collagenases, designed to digest collagen in the key support structures for the cornea (basement membrane, Bowman’s layer, and the stroma). Because collagen is replaced much more slowly than cellular tissues, and because the epithelium requires a healthy collagen substructure for recovery and propagation, DED can become quite problematic once it progresses to the chronic stage. The vicious cycle of tear film deficiency, slowness of collagen recovery, and inflammation make this indication difficult for patients.
Adding tears. Mild cases of dry eyes can often be managed using over-the-counter artificial tear solutions. These can be used as often as needed to supplement natural tear production. Preservative-free artificial tear solutions are recommended because they contain fewer additives, which can further irritate the eyes. People with dry eyes that don’t respond to artificial tears alone will need to take additional steps to treat their dry eyes.
Conserving tears. Keeping natural tears in the eyes longer can reduce the symptoms of dry eyes. This can be done by blocking the tear ducts through which the tears normally drain. The tear ducts can be blocked with tiny silicone or gel-like plugs that can be removed if needed. Or a surgical procedure can permanently close the tear ducts. In either case, the goal is to keep the available tears in the eye longer to reduce problems related to dry eyes.
Increasing tear production.A doctor of optometry can prescribe eye drops that increase tear production. Taking an omega-3 fatty acid nutritional supplement may also help.
Treating the contributing eyelid or ocular surface inflammation. A doctor of optometry might recommend prescription eye drops or ointments, warm compresses and lid massage, or eyelid cleaners to help decrease inflammation around the surface of the eyes.
For Keratitis Sicca, or chronic dry eye, Stuart Therapeutics is taking advantage of PolyCol’s rapid tissue repair capability to directly address the causal tissue damage that results in inflammation for this indication. The ST-100 drug candidate is expected to provide quick relief for ocular surface damage caused by the condition, healing damaged corneal and conjunctival tissues, with patient relief expected in 24 to 48 hours, compared with several weeks for competing alternatives.