Dry Eyes and it’s management for years has concentrated on replacing the water or aqueous component of the tear film. The problem with this approach is that the tear film is also made up of a lipid (oily) layer and a mucin (mucous) layer.
It stands to reason that to achieve successful treatment of dry eye we would also need to pay some attention to the lipid and mucin layers. The lipid layer has taken a lot of the limelight in dry eye management in the last 5 years or so with a number of tear substitutes having lipid additives and the introduction of sophisticated treatments for the meibomian glands that produce the lipid layer.
We are all familiar with the science experiment in high school, which compares water evaporation from an open bowl of water to the same bowel of water, which also has a thin layer of oil placed over the top. Having the oily top layer stops all evaporation of water from the bowl. This can be compared to an eye, which has a healthy oily layer. Evaporation of the water component is significantly reduced, which leads to less dry eye symptoms.
BUT WHAT ABOUT THE MUCIN LAYER?
The mucin layer is produced by the goblet cells of the conjunctiva. It is well known that the mucin layer is extremely important for a healthy eye surface. It forms the first layer that is adjacent to the eye and on it the water and then the oily layer sit on top to complete the lubricating system of the eye. One way to think of the mucin layer is like the foundation of a building. If the foundation is not ample and stable the whole building becomes unstable.
Even though it is well known how important the mucin layer is there has been very few attempts at stimulating or protecting its production within the eye.
Recently a new eye drop currently called MIM-D3 has shown in preliminary trials to significantly reduce the signs and symptoms of dry eyes with just twice a day dosage. MIM-D3 stimulates the production of mucin in the eye. At the end of this year this eye drops will enter what is termed Phase 3 trials. During Phase 2 trials drugs go through rigorous testing to make sure they are safe with minimum complications – apparently MIM-D3 passed with flying colours. Phase 3 trials take the medicine to a large group of patients to prove efficacy and safety before finally being release for general usage.
More on MIM-D3 can be found HERE.
At The Eye Practice Dr Jim Kokkinakis sees patients that suffer from dry eye every day. Dry Eyes are not only common but also what is termed multifactorial. There does not seem to be just one treatment that helps every dry eye patient. Any new treatment for dry eyes is eagerly anticipated. Call (02) 9290 1899 and make an appointment for a Dry Eye Assessment.