Tear film osmolarity with ocular allergy

This study was just looking at the effect of artificial tears on tear film osmolarity in ocular allergy patients. They measured OSDI symptom scores and clinical signs including tear osmolarity, TBUT and Schirmer 1.

Nothing special here but it caught my eye because the best results were with Thera Tears were the best in the group (they don't say by how much) and Thera Tears, while perhaps not so popular these days, was the drop developed by Jeff Gilbard, an important pioneer in the dry eye world who championed a better understanding of the role of tear film osmolarity. Dr Gilbard also played a prominent role in educating about nutritional supplements for dry eye.

In Vivo. 2018 Mar-Apr;32(2):403-408.
Tear Film Osmolarity in Subjects with Acute Allergic Rhinoconjunctivitis.
Nitoda E1, Lavaris A1, Laios K1, Androudi S2, Kalogeropoulos CD3, Tsatsos M4, Damaskos C5,6, Garmpis N5,6, Moschos MM7.Author information

BACKGROUND/AIM:
Acute allergic rhinoconjuctivitis is the most common form of ocular allergies. The pathogenetic mechanisms are based on an immunoglobulin E (IgE)-mediated hypersensitivity reaction. On the other hand, tear osmolarity has been suggested to be an index of ocular surface damage and inflammation. These data were the motive to investigate the levels of tear osmolarity in subjects with acute allergic rhinoconjuctivitis, before and after administration of artificial tears.

PATIENTS AND METHODS:
Forty-five subjects with acute allergic rhinoconjuctivitis were randomly divided into three groups, based on the type of artificial tears that they received: Group A (Thera tears), Group B (Wet therapy) and Group C (Tears Naturale free). The eye drops were administered six times a day for 60 days and all subjects underwent grading of subjective symptoms and clinical examination at baseline and at the end of the treatment. 

RESULTS:
The diagnosis of severe eye disease, which was based on ocular surface disease index (OSDI; Allergan, Inc, Irvine, CA, USA) and tear osmolarity values, concerned all patients at baseline. Although the administration of artificial tears significantly ameliorated the symptoms and the ocular variables in all groups, the results were better in the first group. Tear osmolarity was strongly and negatively correlated with tear film breakup time (BUT) and Schirmer I test at 2 months. Contrariwise, symptoms were eliminated, when tear osmolarity was decreased. 

CONCLUSION:
Acute allergic rhinoconjuctivitis is characterized by tear hyperosmolarity, which can be rehabilitated with the administration of hypotonic artificial tears.