Vitamin A with Cyclosporine for Dry Eye Syndrome

Dry eye disease is a disorder of the tear film due to tear deficiency or excessive evaporation that causes damage to the interpalpebral ocular surface because of an inflammatory reaction. Anti-inflammatory medications such as corticosteroids, autologous serum, and tetracyclines are commonly used for dry eye syndrome. Vitamin A is essential for maintaining the health of ocular epithelial cells; it affects cellular regulation and differentiation. Topical all-trans retinoic acid ointment is effective in the treatment of severe cases of the ocular surface inflammation. Cyclosporine A inhibits calcineurin with restriction of the expression of certain genes involved in T-cell activation. Cyclosporine 0.05% is the first commercially available therapy for dry eye disease that actually increases the production of natural tears. Both vitamin A eye drops and topical 0.05% cyclosporine A treatments can improve symptoms of blurred vision, tear film breakup time, Schirmer I score, and impression cytologic findings in severe dry eye syndrome.