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New Drops Offer Hope for Dry Eyes

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WebMD Health News

April 12, 2000 (Los Angeles) -- If you're one of the millions of people who have dry-eye disease, take note: Eye drops containing the drug cyclosporine significantly improve the symptoms of dry-eye disease and could be a huge breakthrough in the treatment of this stubborn and irritating condition, say the authors of a study in the journal Ophthalmology.

In dry-eye disease, the immune cells in your eye increase the concentration of substances that inflame the eye, leading to tissue destruction and causing more substances that inflame the eye to be released in the tears. This sets up a vicious cycle in which the inflammation attracts and activates more immune cells, which in turn release more inflammatory substances that irritate the eye. Symptoms include blurred vision, extreme sensitivity to light, and an itching or a "gritty" feeling in the eye. In extreme cases, it can cause blindness.

"Cyclosporine prevents activation of the [immune] cells and also seems to help certain cells in the tear glands live longer because there is no more inflammatory response," says co-author Thomas K. Mundorf, MD, an ophthalmologist in private practice in Charlotte, N.C. "Then you get improved function of the tear gland, which secretes a more normal tear."

Until now, the only treatments ophthalmologists had for dry-eye disease were artificial tears or plugs in the tear ducts, both of which were ineffective in many patients. Steroid drops offered a bit more relief but had serious side effects.

Mundorf tells WebMD that plugs blocked the tears, preventing drainage, but that may have kept the inflammatory substances in the eye. "The exciting thing to me is [that] what we have with cyclosporine is a way to intervene. It's been kind of remarkable in some of these patients. You feel like you're doing something for them," he says.

Mundorf estimates that 12 million to 20 million people in the U.S. suffer from dry-eye disease, compared to 3 million to 6 million people with glaucoma. Seen most often in women who have been through menopause, dry-eye disease also is associated with certain forms of eye trauma, injury, and an abnormality of the tear duct glands or eyelids. Diseases such as rheumatoid arthritis, and some drugs such as beta-blockers, commonly prescribed to treat high blood pressure, also can cause dry-eye disease.

Doctors also are seeing more and more cases among patients who have undergone corneal laser surgery to correct nearsightedness.

In the study, the investigators, led by Kenneth Sall, MD, looked at nearly 670 patients who completed the six-month trial. They tested cyclosporine in two concentrations: 0.05% and 0.1%, each administered as one eye drop twice a day.

A third group received dummy drops that contained no drug twice a day. Patients were allowed to use artificial tears as needed up to month four, but could not administer them 30 minutes before or after taking the study medication to prevent dilution of the medication.

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