Dry eyes are a common and often very stressful condition, especially in older people. Those affected suffer from burning, a foreign body sensation, redness, itching and rapid eye fatigue – for example when reading or working at a computer screen. Artificial tears are usually used, but these often only help for a short time.
This clinical study investigated whether sterile isotonic seawater is more effective than conventional artificial tears based on carmellose for eye cleansing and moisturizing.
The results clearly show that people who regularly used isotonic seawater reported greater and more lasting relief from their symptoms. In particular, symptoms such as dryness, burning, itching, redness and foreign body sensation improved noticeably more than when artificial tears were used.
Another important finding was the significant decrease in inflammatory messenger substances in the tear fluid. These substances play a central role in the development and maintenance of dry eyes.
The seawater was very well tolerated and there were no side effects.
Conclusion: Isotonic seawater is a well-tolerated and effective alternative to classic artificial tears and can significantly alleviate the symptoms of dry eyes.
Background
Dry eye syndrome is a multifactorial disease of the ocular surface characterized by impaired stability of the tear film and chronic inflammatory processes. In addition to the unpleasant foreign body sensation, the disease significantly impairs the quality of vision and quality of life.
Artificial tears are the standard therapy, but often only provide short-term wetting without sufficiently influencing the underlying inflammatory processes. There is therefore a need for forms of therapy that have both a soothing and inflammation-modulating effect.
Isotonic seawater has a special mineral composition with a high proportion of magnesium, potassium and bicarbonate and a comparatively low sodium content. These properties are expected to have anti-inflammatory, cleansing and moisturizing effects.
Study design
The study was conducted as a prospective, randomized, multicenter comparative study. Participants with moderate to severe dry eye were treated for twelve weeks with either:
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a sterile isotonic seawater spray or
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artificial tears based on carmellose
treated. Both applications were carried out several times a day.
Subjective complaints, clinical findings on the ocular surface and inflammatory markers in the tear fluid were recorded.
Central results
Significantly stronger symptom relief
Patients who used isotonic seawater showed a significantly greater improvement in their subjective symptoms. The relief was particularly pronounced for irritation symptoms such as dryness, burning, itching, redness and foreign body sensation.
Reduction of inflammatory processes
In the seawater group, there was a significant reduction in important inflammatory messenger substances in the tears. This reduction was more pronounced than when artificial tears were used and indicates an active anti-inflammatory effect.
Comparable effect on the ocular surface
Both forms of treatment improved objective findings on the cornea and conjunctiva. There were no significant differences between the groups, indicating that seawater protects the ocular surface at least as well as artificial tears.
Very good compatibility
The isotonic seawater was well tolerated by all participants. Neither irritation nor side effects occurred, which allows frequent and long-term use.
Mechanisms of action
The authors attribute the effect of seawater to several factors:
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Moisturizing the surface of the eye
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Dilution and washing out of flammable substances
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Anti-inflammatory effect of the minerals
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Mechanical cleaning effect (“wash and rinse effect”) instead of pure lubrication
This approach differs fundamentally from artificial tears, which primarily only wet the skin.
Significance for practice and care
The results show that isotonic seawater is not only a symptom-relieving but also a pathophysiologically useful supplement in the treatment of dry eyes. It can be a valuable alternative, particularly in cases of chronic symptoms and inadequate response to artificial tears.
Conclusion
Isotonic seawater is a safe, well-tolerated and effective treatment option for dry eye. It reduces symptoms more than conventional artificial tears and at the same time reduces inflammatory processes on the surface of the eye.
The study suggests that seawater can be used not only as a moisturizer, but also as a functional therapy to interrupt the inflammatory cycle in dry eye.