– What are eye drops, how do they differ?
– Drops can be divided into those used for treatment and those necessary for the prevention of eye diseases.
Medicinal drops contain anti-inflammatory drugs – they are used with conjunctivitis or allergies in the postoperative period. Antibacterial drops are also therapeutic – they are prescribed by a doctor and dispensed by prescription in pharmacies. The doctor must observe his movements dynamically. Another large group of therapeutic agents are glaucoma drugs. They are also effective, they often contain substances that can affect the body as a whole. For example, drops for glaucoma often contain a fixed combination, prostaglandin analogues and beta-blockers. And as you know, beta-blockers are used in cardiology for rhythm disorders, chronic heart failure. For example, they can be dangerous for bronchial asthma, arrhythmias and rare heart diseases. Therefore, they are prescribed very carefully.
All these drugs are dispensed with a prescription in the pharmacy.
– Can you freely buy preventive drugs?
– Yes. These are usually antioxidants, vitamins. Such drugs are prescribed for a long time, as they support and nourish the cornea, conjunctiva and other intraocular structures. Most often, these drugs are prescribed for the prevention of diseases of the cornea, lens, retina, optic nerve.
Antioxidants drip to prevent age-related retinal degeneration. The most famous antioxidant is Emoxipin or Viksipin.
What vitamins are usually prescribed?
– Usually these are taurine-containing preparations containing selenium. They have proven themselves very well in containing cataracts, an age-related disease. We often prescribe these drops in patients with initial cataracts to stabilize function so it doesn’t progress. Taurine and selenium penetrate the cornea into the lens very well and maintain the protein bonds within the lens. Also, drugs such as the well-known Taufon, for example, are harmless. And after 60 years, anyone can already drip them.
Do vitamins penetrate the eyes well?
– It’s just too bad. To protect the intraocular membranes, we have a very strong hemato-ophthalmic barrier that does not allow any extra substance to enter the eye cavity. Therefore, if we want to bring a substance into the eye cavity, we do so through the blood. That is, we prescribe vitamin preparations to patients in the form of capsules or injections.
– So drops with vitamins, for example, the Japanese, which have become so popular in Russia, do not work?
– They act only on the surface of the eye: on the conjunctiva or cornea or on the eyelids. They don’t get in your eyes. Exception: the taurine and selenium I mentioned above.
– If you read the composition of the Japanese Rohto drops, which are abundant in the markets, there is lutein, vitamin A, B vitamins, vitamin C, vitamin E, selenium, beta-carotene. What can you say about this composition?
– The composition is very good if we take it orally. As I said, all these substances will only affect the surface of the eye, that is, only the eyelids, conjunctiva and cornea. They cannot enter the eye due to the strong hemato-ophthalmological barrier.
– Does the vitaminization of the surface of the eyes bring at least some benefit?
“We have to deal with each particular case. Sometimes we prescribe such drugs, for example, to treat superficial changes present in the eyes. For example, an ulcer or corneal erosion can be treated in this way. In this case, vitamins can help us in complex therapy. But they themselves do not have any therapeutic effect, only in combination.
Often manufacturers claim that their drops treat dry eye syndrome very well. Again, these trace elements and vitamins have a place in the complex treatment of dry eye syndrome. But here it is imperative to look at the composition of preservatives, do they contain preservatives allowed in Russia and how sterile are the drops?
Recently, there was a sensational story when untested and untested drops for dry eye syndrome were sold on the mass market, which led to massive infections of the conjunctiva with erosion, corneal ulcers, which later turned into very serious complications. visual acuity. But this, fortunately, was not in Russia.
– Should sterility be written on the packaging?
–Yes. However, in order not to risk your eyes, you only need to buy eye drops from pharmacies.
– The freshness index in Japanese drops is also displayed from zero to five. If this index is 4 or 5, then the drops already quite strongly burn the eyes when applied. Isn’t it harmful at all?
– Indeed, many Asian countries use menthol in the composition for the treatment and prevention of dry eye syndrome. Menthol has a local vasoconstrictor effect and an irritating effect on the eye surface. Due to this effect, its own tear production takes place. And indeed – for a short time the person feels relieved, because the tear has developed, has washed the conjunctiva and cornea, and therefore there is a certain feeling of freshness.
However, dry eye syndrome is characterized by the imperfection of its own tears.
– What is his inferiority?
– When the osmolarity increases the content of various salts and acids that disrupt the neutral pH of the tears. Dry eye rises and the tear itself can cause irritation. But it still causes the same defective tear to be produced. It’s a vicious circle.
That’s why we prescribe artificial tears or lubricants to break this vicious cycle. They are exactly the same as natural tears as osmolar, so they moisturize the eye well. And against this background, you do not need to stand out with your vile tears.
Preparations for the treatment of dry eye syndrome in our country almost always contain hyaluronic acid.
— So, there is no point in treating dry eye without hyaluronic acid?
– Yes. Hyaluronic acid attracts water molecules and keeps them on the eye surface for a long time, thus keeping the eye moist for a long time.
In the complex we still write down Skulachev’s drops. This drug, patented in Russia, is approved for use. Its composition is absolutely sufficient and has been proven in all clinical studies. It is a very powerful mitochondrial antioxidant. But still this is a complex therapy, nevertheless, it can not do without lubricants, artificial tears.
– Should a person over 50 take Skulachev’s drops if he wants to prevent age-related eye diseases?
“This is great for preventing age-related diseases. It only needs to be dripped in classes, not always. We drip for a month, then take a break for 2 months and you can drip again. Just like Taufon.
– In some drops, chondroitin is also in the composition. Does it work somehow?
– Chondroitin is part of all the fluids in our body. But we rarely use it for prevention purposes. But we add it to medicinal ointments. But they are used when there is some kind of damage to the cornea – erosion, ulcers or other degenerative changes. For prevention, I see no reason to use it.
– What can you say about adding anti-allergic effective antihistamines to the drops?
– All drops associated with antihistamine molecules should be prescribed only by a doctor. Because allergic conjunctivitis is a very complex nosology. In no case should such drops be purchased independently without a prescription.
– Even the drops contain borax, boric acid, sodium edetate, polyoxyethylene, chlorobutanol, castor oil…
– These are all preservatives that are not allowed in Russia.
What about benzalkonium chloride?
— Benzalkonium chloride and polyquat are allowed here. But we must understand that the more preservatives used in the drops, the worse it is for the eyes.
As for benzalkonium chloride and polyquat, it is allowed only in small concentrations, that is, in microdoses, so as not to cause injury to the cornea, conjunctiva, eyelids and not cause any adverse chemical or toxic, allergic reactions. In addition, they themselves are very strong oxidants.
All this has been very carefully tested. However, preservative-free drops are now gaining popularity. That is, these are single-dose drops in which only the active substance and hyaluronic acid are present. These drops are absolutely safe. They do not dry out the eyes and are indicated for patients who use them for long periods of time.
– Are they more expensive?
Yes, they are more expensive. 2 times exactly. They are either sold in disposable packaging – that is, opened, dripped and discarded. Or there are drops without preservatives – in special patented bottles.
– Sometimes fluorophenylfenicol is added to the drops. What’s this?
– This is chloramphenicol – an antibiotic. Antibiotics are only available by prescription.
– Drops are sold under the name “Aloe extract according to Filatov.” Is aloe extract worth dripping into the eyes?
– Aloe, of course, is a biologically active substance. It used to be actively used in the Soviet Union. But now it is not used due to insufficient efficiency.
– Biokedravit eye drops are also sold. The instructions say it has no side effects and even cures the spur. The active ingredient is cedar resin.
– It’s terrible. I think that cedar resin contains caustic esters, which in high concentrations can even be harmful to the eyes.
— So-called Ayurvedic drops are often sold in markets. They contain various plant extracts. Is it worth leaving them?
– All these are unknown and unregistered compounds. Herbal drops can cause allergic reactions in any patient. And not just the eyes, but the whole body. This applies to all drops based on plant extract.
And once again I want to encourage everyone to buy eye drops only in pharmacies.