FRIDAY, Oct. 31, 2003 (HealthDayNews) -- Dry eye syndrome is a common side effect of aging and some autoimmune diseases that has traditionally been treated with drops called artificial tears which irrigate the eyes.
But a new eye drop medication helps the body actually increase its own tear production, a new study says.
In a study of 877 patients with moderate to severe dry eye, approximately 60 percent improved their tear production over a six-month period by using a new medicine containing cyclosporine, says study author Dr. Scott Whitcup.
Whitcup is a California rheumatologist who presented the findings Oct. 24 at the American College of Rheumatology's annual scientific meeting.
He also heads clinical research for Allergan, an Irvine, Calif.-based company that manufacturers the drug, sold under the name Restasis. The U.S. Food and Drug Administration approved the drug last December.
"Topical cyclosporine substantially increases tear production in patients with dry eye, not only in patients with autoimmune diseases like Sjögren's syndrome, but also in patients without autoimmune disease," Whitcup says. "The increased tear production was associated with less surface damage to the patients' corneas, so they had less blurring of vision. Also, they used 33 percent less artificial tears."
Dry eye syndrome, formally known as keratoconjunctivitis sicca, is a persistent dryness of the cornea due to decreased function of the tear glands or increased evaporation of tears.
Sufferers experience constant pain from eye irritation, and a sandy or gritty sensation that, if untreated, can lead to scarring or ulceration of the cornea, and eventually loss of vision.
An estimated 10 million Americans suffer from dry eye syndrome, according to the Schepens Eye Research Institute in Boston. Most cases result from normal aging of the eyes' tear glands, but dry eye can occur at any age. It affects women more than men. About 3 million Americans have dry eye as a side effect of Sjögren's syndrome, an autoimmune disease. It also affects about a third of people with other autoimmune diseases such as rheumatoid arthritis. The condition can also be a side effect of drugs used to treat high blood pressure, allergy and depression, Whitcup says.
"It is very uncomfortable and the ocular surface is not protected," says Dr. John W. Shore, an ophthalmic surgeon in Austin, Texas, and president of the American Society of Ophthalmic Plastic and Reconstructive Surgery.
Shore says he's "very familiar with the drug and [I] have started using it in my practice. It seems to work the best in those patients who have autoimmune diseases, but is also good for dry eye in general because it allows the tear film [a layer of mucus that protects the eye] to stabilize and produce more of a person's natural tears, which is healthier for the eye."
He notes, however, the drug takes some time to start to work, usually about three months of twice daily drops, and is expensive, about $100 a month. So Shore only recommends it for severe dry eye.
"For people who have mild dry eye due to allergies or wind burn, artificial tears is very reasonable. But if I have a patient who's using artificial tears every hour and who has rheumatoid arthritis, he may be a candidate for the drug," Shore says.
Cyclosporine is a common immunosuppressive drug that is given orally to treat inflammation in certain autoimmune diseases and to prevent transplant rejection. But this topical use of the drug for dry eye has a very small concentration, so it is absorbed into the eye tissue but not detected in the blood, Whitcup says.
"This is important because it makes development of side effects less likely," he says.
More information
For more information on dry eye syndrome, visit the Schepens Eye Research Institute. Information about Sjögren's syndrome can be found at the National Institute of Neurological Disorders and Stroke.
