Alcon. Tears Naturale. Available at: www.tears naturale.com/tears-naturale-bion-tears.asp (Accessed January 2009). Among all therapeutic options for dry eye disease, artificial tears are still the mainstay in the initial management of a dry eye patient. 7 Ophthalmic physicians usually begin a newly-diagnosed dry eye patient on a regimen of topical artificial tears and then add to or modify the course of treatment from there. Estimates of the prevalence of dry eye vary considerably between different populations of the world. In the United States, it is thought that dry eye occurs in 5% to 30% of the population. 3 As practitioners, we are well aware that this disease affects women more than men and also increases in incidence in the older population. 3

Also, the increased retention time may be responsible for the increase in tear film break-up times observed with HP guar-based artificial tears compared to CMC-based tears. 13 Tear evaporation may be reduced by the use of HP guar containing artificial tears. 14 So, HP guar-based artificial tears may be helpful in patients with conditions causing evaporative dry eye (e.g., meibomian gland disease) as well as patients demonstrating ocular surface staining. A wide variety of therapeutic options are available for dry eye disease. Various treatment strategies, such as artificial tears or rewetting agents (henceforth called artificial tears), punctal plugs, anti-inflammatory agents (topical steroids or oral fatty acids), moisture goggles, secretogogues, autologous serum, prescription immunomodulatory drugs (topical and oral) as well as surgical options, are available for the treatment of dry eye disease. The epidemiology of dry eye disease: report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf 2007;5(2):93-107.Murube J, Paterson A, Murube E. Classification of artificial tears. I: Composition and properties. Adv Exp Med Biol 1998;438:693-704. The diagnostic challenge is further increased for dry eye disease because no single test is available to correctly diagnose its various forms. Current research suggests that inflammation at the ocular surface plays an important role in the pathogenesis of dry eye. 6 Simmons PA, Vehige JG. Clinical performance of a mid-viscosity artificial tear for dry eye treatment. Cornea 2007;26(3):294-302. EvoTears ® are the first water-free drops in the treatment of dry eyes, as they contain only the substance perfluorohexyloctane. Thus EvoTears ® does not require any additives such as preservatives, phosphates or emulsifiers.

EvoTears ® is lipophilic, thanks to the innovative substance perfluorohexyloctane, and yet has the same refractive index as the tear. Thus, vision is not impaired.Evotears silmätipat on tarkoitettukuiville ja vuotaville silmille.Voitelee, tasapainottaa kyynelkalvoa ja lievittää kuivien silmien oireita.

Reddy P, Grad O, Rajagopalan K. The economic burden of dry eye: a conceptual framework and preliminary assessment. Cornea 2004;23(8):751-61. EvoTears is preservative, phosphate and water-free making it suitable for daily management of Dry Eye & MGD.The meibomian glands are located in the upper and lower eyelids and exit onto the eyelid margins. These glands are responsible for the tear film’s lipid layer as they release an oily secretion directly on the lid margins. Thus, each blink leads to the renewal of the lipid layer, which prevents premature evaporation and destabilisation of the tear. Dry eye disease is observed often in our practice as primary eye care providers. In general, dry eye is characterized as a disease that occurs due to increased tear evaporation or decreased tear secretion that resulted in symptoms of ocular irritation. 1 FreshKote eyedrops (Focus Laboratories) are the only brand of artificial tears that require a prescription. The main ingredients of FreshKote include PVA as well as polyvinyl pyrrollidone. FreshKote also includes the companys proprietary Amisol Clear which is intended to stabilize the lipid layer of the tear film and prevent evaporation of the tear fluid. Because the manufacturer of FreshKote describes Amisol Clear as a phospholipid, FreshKote functions somewhat akin to the oil-based tears. Additionally, these eyedrops are designed to achieve better wetting by aiding the combination of all three layers of the tear film. FreshKote has a high oncotic pressure, which helps in increasing ocular surface integrity. 28 And, FreshKote can be used daily on an as needed frequency. 28