The optical function of the eye critically depends on the presence of an intact precorneal tear film. Abnormalities of the tear film such as those occurring in the dry eye syndrome or in otherwise irritated eyes may interfere with vision. In 30 patients with dry eyes artificial tears were found to produce stastistically significant improvement of vision (p<0001) while no significant changes were seen in the untreated partner eyes. Static perimetry in another 30 patients using the 'macular programme' of the automatic Humphrey 620 perimeter showed artificial tears to increase mean thresholds significantly (p

Disturbances of the lipid composition can, like mucin or fluid deficiency, cause ‘dry eye’. The substitution of the lipids of the tear fluid has previously been unsatisfactory since eye ointments containing fats can lead to a considerable deterioration of the visual acuity due to the film of ointment resulting from an irregular spreading behavior. We proposed the introduction of physiological lipids that are normally present in tear fluid, such as phospholipids, saturated and unsaturated fatty acids and triglycerides, to provide lipid-containing eye drops. These best correspond to ‘natural tears’ and, due to the small size of the lipid particles, avoid a disturbance of the spreading behavior of the lipid layer. With lipid-containing eye drops of this kind, we carried out the following examinations: inquiry of patients’ symptoms based on a standardized interview; Schirmer test under local anesthesia; break-up time (BUT); biomicroscopic evaluation of the lipid film, and stability tests as pH, gas chromatographic analysis of the fatty acid pattern and thin-layer chromatographic analysis of the lipid pattern. Schirmer test, BUT measurement and questioning about symptoms were undertaken after 1 week and then again after 3 weeks of treatment. All three parameters finally showed an improvement with a high statistical significance (p < 0.001). The stability tests have shown that pH, lipid particle size, fatty acid and lipid composition of the examined lipid-containing eye drops were nearly unchanged till 4 months after preparation.

Background/aims: Among the causes related to the development or perpetuation and aggravation of dry eye disease, oxidative reactions may have a role in the pathogenesis of this disorder. Antioxidants, such as iodide, have shown a strong effect in preventing the oxidative damage to constituents of the anterior part of the eye. In this clinical trial the effectiveness of iodide iontophoresis and iodide application without current in moderate to severe dry eye patients was compared. Methods: 16 patients were treated with iodide iontophoresis and 12 patients with iodide application without current for 10 days. Subjective improvement, frequency of artificial tear application, tear function parameters (break up time, Schirmer test without local anaesthesia), vital staining (fluorescein and rose bengal staining) as well as impression cytology of the bulbar conjunctiva were evaluated before treatment, 1 week, 1 month, and 3 months after treatment. Results: A reduction in subjective symptoms, frequency of artificial tear substitute application, and an improvement in certain tear film and ocular surface factors could be observed in both groups. A stronger positive influence was seen after application of iodide with current (iontophoresis), as observed in a distinct improvement in break up time, fluorescein and rose bengal staining, and in a longer duration of this effect compared with the non-current group. No significant change in Schirmer test results and impression cytology were observed in both groups. Conclusions: Iodide iontophoresis has been demonstrated to be a safe and well tolerated method of improving subjective and objective dry eye factors in patients with ocular surface disease.

Poor stability of the precorneal tear film causes dry eye symptoms and has detrimental effects on the optical function of the eye. In 50 patients with dry eyes the local instillation of artificial tears significantly improved contrast sensitivity (P < 0.001), using the Vision Contrast Test System 6500. In the untreated eyes no significant changes were found to occur (P = 0.56).

Zusammenfassung.Hintergrund: Sowohl eine erhohte UVEinstrahlung als auch Ozon stellen eine Belastung fur die in der Tranenflussigkeit vorhandenen Schutzmechanismen dar. Freie Radikale konnen dabei die im Tranenfilm enthaltenen Proteine, Mucosubstanzen and Lipide zerstoren. Als Folge entsteht das sogenannte ,Trockene Auge".Ziel dieser Studie sollten Untersuchungen zur Frage sein, inwieweit die Anwendung der iodhaltigen Kurmittel Bad Halls den ,Gesamtantioxidativen Status" der TranenflUssigkeit beinflussen konnen.Material and Methoden: 66 unausgewahlte Bad Haller Kurpatienten, mit and ohne Beschwerden des "Trockenen Auges" in der Anamnese, wurden zur Untersuchung herangezogen. Mittels Mikrokapillaren mit einem Fassungsvermogen von 4 µl erfolgte die Tranenabnahme vor Kurbeginn and nach Kurende. Das antioxidative Potential der verschiedenen Tranenflussigkeitsproben wurde photometrisch bestimmt.Ergebnisse: Die Auswertung des antioxidativen Gesamtpotentials von 127 Tranenfliissigkeitsproben ergab einen signifikanten Anstieg von 0,312 nmol/µl am Kuranfang auf 0,831 nmol/µl zum Kurende.Dabei wurde deutlich, dass Kurgaste in allen Altersgruppen einen signifikanten Anstieg des antioxidativen Potentials nach Absolvierung einer Augenkur erreichen.Schlussfolgerungen: Diese Studie zeigte, dass die in Bad Hall angewendete Jodkurbehandlung zur Verbesserung des antioxidativen Schutzmechanismus beitragen kann. Eine Erhohung des natiirlichen antioxidativen Schutzpotentials reduziert die Moglichkeiten fiir den Angriff von freien Radikalen, die eine der Ursachen fur die Entstehung des Syndroms ,Trockenes Auge" sein konnen. Durch eine verbesserte Abwehrkraft des Tranenfilms gegenuber ,,oxidativem Stress" lielle sich das Risiko fur das Auftreten des umweltinduzierten trockenen Auges vermindern, wobei die mogliche Wirkung von Iodidionen als Sauerstoffradikalfanger diskutiert wird.

There is a time-dependent protective influence of iodide against selenite cataract development. It is supposed that the anticataract effect of iodide could be based on direct or indirect antioxidant mechanisms.

Iodine distribution was studied in isolated porcine eyes after iontophoresis using ¹³¹l-labelled solutions and chemical methods. After a 15-min treatment with a therapeutically used iodine brine, the iodine content in the ocular tissues showed the following rank order: cornea > retina > vitreous body > anterior chamber fluid > lens. Replacement of the brine by 0.15 MNal increased the uptake values in a different way, but the same rank order was maintained. The increase was highest in the cornea (5.6-fold) and only about 2-fold in the lens, nevertheless approaching now the level of 10^––4 M, a concentration which was regarded as being optimal for the antioxidant effect of I^––. Among the other eye components, the relatively high iodine enrichment of the retina was remarkable. The data are discussed with respect to a possible protective, antioxidative and OH-scavenging efficacy of I and to previous results in the literature concerning iodine uptake in ocular tissues.

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