515 Over-the-counter artificial tears effective for dry eye syndrome

August 25, 2017

written by Brian R McAvoy.

Clinical question
How effective are over-the-counter (OTC) artificial tear drops in the treatment of dry eye syndrome?

Bottom line
Comparing between classes of OTC artificial tears, and compared with no treatment or placebo, OTC artificial tears were effective at treating dry eye syndrome, and were generally safe, although not without side effects (blurred vision, ocular discomfort and foreign body sensation). Polyacrylic acid-based artificial tears (0.2%) were consistently more effective at treating dry eye syndrome than 1.4% polyvinyl alcohol-based artificial tears in 2 trials comparing these products (175 participants). All other included artificial tears produced contradictory between-group results or found no between-group differences.

Caveat
The overall completeness of the included trials was limited by factors such as being short-term, incomplete investigator masking, industry support bias and incomplete data reporting. Thus, the overall quality of the evidence is low.

Context
OTC artificial tears, historically, have been first-line treatment for dry eye syndrome and dry eye-related conditions like contact lens discomfort, yet, currently, little is known regarding the overall efficacy of individual commercially available artificial tears.

Cochrane Systematic Review
Pucker AD et al. Over the counter (OTC) artificial tear drops for dry eye syndrome. Cochrane Reviews, 2016, Issue 2. Art. No.: CD009729.DOI: 10.1002/14651858. CD009729.pub2. This review contains 43 studies involving 3497 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.