1. Clinical Overview
A sterile, topical ophthalmic solution combining a lubricating and mucoadhesive polymer (Carboxymethylcellulose) with a hyperosmotic demulcent (Glycerin). It acts as an artificial tear and ocular lubricant to protect and hydrate the ocular surface, mimicking the properties of natural tears. It is a first-line therapy for dry eye disease (DED) in the Indian population, where environmental factors like pollution and low humidity are significant contributors.
| Onset | Duration | Bioavailability |
|---|---|---|
| Immediate (within 1-2 minutes of instillation). | Approximately 60-90 minutes per instillation, depending on the severity of tear film deficiency. | Topical ocular; systemic absorption is negligible (<1%). |
2. Mechanism of Action
The combination provides dual-action relief for dry eyes. Carboxymethylcellulose (CMC) is a long-chain polymer that binds to the mucin layer of the tear film, increasing its viscosity and stability, prolonging residence time on the ocular surface, and protecting corneal and conjunctival epithelial cells. Glycerin, a trihydric alcohol, acts as a hyperosmotic agent, drawing water from the corneal stroma and conjunctival tissue into the tear film, thereby hydrating the ocular surface and relieving symptoms of dryness and grittiness.
3. Indications & Uses
- Dry Eye Disease (DED) / Keratoconjunctivitis Sicca (KCS) of various etiologies (aqueous-deficient, evaporative)
- Symptomatic relief of dry eye due to environmental factors (air conditioning, pollution, low humidity common in many Indian regions)
- Post-operative ocular surface discomfort (e.g., after cataract, LASIK, PRK)
4. Dosage & Administration
Adult Dosage: Instill 1-2 drops into the affected eye(s) as needed, typically 3 to 4 times daily. Frequency can be increased based on symptoms, up to every 1-2 hours for severe dryness.
Administration: 1. Wash hands before use. 2. Tilt head back. 3. Gently pull down the lower eyelid to form a pouch. 4. Hold the dropper close to the eye without touching it. 5. Instill the prescribed number of drops. 6. Close eyes gently for 1-2 minutes, applying light pressure to the inner corner (nasolacrimal duct) to minimize systemic drainage. 7. Do not touch the dropper tip to any surface to avoid contamination. 8. Can be used with contact lenses; instill drops before inserting lenses or after removing them, unless specified for use with lenses on.
5. Side Effects
Common side effects may include:
- Transient mild blurring of vision immediately after instillation (lasts a few minutes)
- Mild ocular discomfort or stinging upon application
- Sticky sensation on eyelids
6. Drug Interactions
| Drug | Effect | Severity |
|---|---|---|
| Other topical ophthalmic medications (e.g., antibiotics, glaucoma drops, cyclosporine) | Physical incompatibility or dilution. May reduce efficacy of other drugs if instilled simultaneously. | Moderate |
| Eye ointments | Artificial tear solution may not penetrate the ointment layer effectively. Administer drops at least 10-15 minutes before ointment. | Moderate |
7. Patient Counselling
- DO wash hands before use.
- DO wait at least 5-10 minutes between instilling this and any other eye drops.
- DO store in a cool, dry place away from direct sunlight.
- DO discard the bottle 30 days after opening to prevent contamination.
- DON'T touch the dropper tip to your eye, fingers, or any surface.
- DON'T use if the solution changes color or becomes cloudy.
- DON'T wear contact lenses if your eyes are red or irritated unless advised by your doctor.
8. Toxicology & Storage
Overdose: Accidental ingestion of bottle contents is unlikely to cause serious toxicity due to low volume and low toxicity of ingredients. Symptoms may include mild gastrointestinal upset (nausea, diarrhea). Ocular overdose (excessive drops) will only lead to temporary blurred vision and stickiness.
Storage: Store at room temperature (15°C to 25°C). Do not freeze. Keep the bottle tightly closed when not in use. Protect from light. Keep out of reach of children. Discard any unused solution 30 days after first opening the bottle. Do not use after the expiry date printed on the pack.