Artificial Tears:A Systematic Review


Artificial tears are the mainstay of dry eye disease management, but also have a role in corneal abrasion and wound healing, pain and inflammation management, conjunctivitis, keratitis, contact lens rewetting and removal, and foreign body removal. A systematic review of randomized controlled trials (PROSPERO registration CRD42022369619) comparing the efficacy of artificial tears in patients with dry eye to inform prescribing choices using Web of Science, PubMed and Medline databases identified 64 relevant articles. There is good evidence that artificial tears improve symptoms of dry eye disease within a month of regular use, applied about four times a day, but signs generally take several months to improve. Not all patients with dry eye disease benefit from artificial tears, so if there is no benefit over a month, alternative management should be considered. Combination formulations are more effective than single active ingredient artificial tears. Artificial tears containing polyethylene glycol are more effective than those containing carboxymethylcellulose/carmellose sodium and hydroxypropyl methylcellulose. Those classified as having evaporative dry eye disease, benefit from artificial tears with liposomes, especially of higher concentration. The data available is limited by the definition of dry eye disease applied in published studies being variable, as well as the disease severity examined and compliance with artificial tears being rarely quantified.

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Divisions: College of Health & Life Sciences > School of Optometry > Optometry
College of Health & Life Sciences > School of Optometry > Optometry & Vision Science Research Group (OVSRG)
College of Health & Life Sciences
College of Health & Life Sciences > School of Optometry > Vision, Hearing and Language
Funding Information: JSW is on the executive of the Tear Film and Ocular Surface Society and the Aston University Optometry Research Group have received research funding from Alcon, the Eye Doctor, Scope Ophthalmic and Thea Pharmaceuticals. No funding was received to conduct
Additional Information: Copyright © 2023 Semp et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (
Uncontrolled Keywords: artificial tears,comfort,contact lenses,dry eye,Ophthalmology,Sensory Systems
Publication ISSN: 1444-0938
Last Modified: 18 Jul 2024 07:19
Date Deposited: 20 Jan 2023 13:30
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Related URLs: https://www.dov ... xt-article-OPTO (Publisher URL)
http://www.scop ... tnerID=8YFLogxK (Scopus URL)
PURE Output Type: Review article
Published Date: 2023
Published Online Date: 2023-01-10
Accepted Date: 2022-12-17
Authors: Semp, David A
Beeson, Danielle
Sheppard, Amy L (ORCID Profile 0000-0003-0035-8267)
Dutta, Debarun (ORCID Profile 0000-0002-2204-5272)
Wolffsohn, James S (ORCID Profile 0000-0003-4673-8927)


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