Ophthalmic lubricating ointments are similar to artificial tears in their makeup. In addition, ointments contain emollients such as petrolatum, mineral oil, and lanolin. Applied as a small ribbon to the inferior cul-de-sac, these products dissolve at ocular surface temperature, spread with the tear film, and lubricate and protect the tissues. The increased contact time and viscosity of ophthalmic lubricating ointments make them very useful in the treatment of severe dry eye or in cases of exposure secondary to nocturnal lagophthalmos (a condition where the lids do not entirely close during sleep). Though ointments have advantages, their major drawback, like all ophthalmic ointments, is the transient blurring of vision. Ointments are, thus, used primarily at night, unless the dry eye is significant enough to warrant otherwise. A list of selected lubricating ointments is provided in Table 5-4.
Sometimes, a patient will use a viscous artificial tear preparation such as Celluvisc® for nighttime use rather than an ointment. These viscous solutions do not have the prolonged contact time or lengthy staying power necessary for nighttime use.
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