OCULAR SURFACE INFLAMMATION IN DRY EYE CAUSED BY ELEVATED TEAR FILM OSMOLARITY.

WOBURN, MA, November 2, 2005--Elevated tear film osmolarity causes the recently touted ocular surface inflammation in dry eye, according to a new study published this month by Luo, Li Corrales and Pflugfelder. Scientists had argued whether increased tear film osmolarity caused the ocular surface inflammation in dry eye, or whether the ocular surface inflammation caused the increased tear film osmolarity.
In 1976 Jeffrey P. Gilbard, MD hypothesized that elevated tear film osmolarity caused the symptoms and surface disease of dry eye, and subsequently, over a 20-year period, in research sponsored by the National Eye Institute, was able to demonstrate that all of the morphological changes on the ocular surface in dry eye were dependent upon, proportional to and consistent with increased tear film osmolarity.  This work lead to the development, first of HypoTears, and then the still more hypotonic TheraTears line of artificial tears. 
Recently cyclosporine (Restasis) has been approved for the treatment of dry eye, but the drug was unable to achieve claims that it reduced patient symptoms.  Soft steroids have also gained some use in attempts to treat dry eye, but also have failed to achieve claims that they reduce dry eye symptoms.  “We know that ocular surface inflammation peaks in the morning.  In dry eye, symptoms and osmolarity increase as the day goes on.  This explains why topical immunosuppressant and anti-inflammatory eye drops have not been shown to have a beneficial effect on dry-eye symptoms in double-masked studies,” said Dr. Gilbard, who wrote the editorial that accompanies the new article.  “This new work confirms our earlier work, and explains why patients improve with hypotonic tears, punctal plugs, hot compresses,  and moist chambers—all treatments that help lower elevated tear film osmolarity in dry eye, reduce patient symptoms,  decrease ocular surface disease, and now, evidently, reduce the secondary ocular surface inflammation.”  .    
“This finding is going to accelerate further improvements in treatment, now that we fully understand dry eye,” added Dr. Gilbard.
The article and accompanying editorial are published in the October 2005 issue of Eye and Contact Lens.  The article can be read online at www.dryeyeblog.com.  

Advanced Vision Research is committed to eye research and the development of major advances in the treatment of eye disease.  It is the single largest benefactor of the Schepens Eye Research Institute.  Information on the company and its products may be obtained by contacting Advanced Vision Research at telephone number 781-932-8327 by fax at 781-935-5075 or by e-mail at info@theratears.com. Information can also obtained by visiting the TheraTears website at www.theratears.com.

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