title: Prospective evaluation of hypromellose 2% for punctal occlusion in patients with dry eye.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of punctal occlusion using hypromellose 2% in patients with dry eye.
  
  
  METHODS
  In this prospective, randomized single-blinded clinical trial, we evaluated 76 eyes of 38 patients (36 women and 2 men) with dry eye secondary to rheumatic diseases. In each patient, the lower lacrimal punctum of 1 eye was occluded using hypromellose 2%, whereas the contralateral eye underwent a simulation of the procedure (control group). Patients' eyes were assessed for burning, itching, redness, foreign body sensation, and tearing based on a visual scale questionnaire (score, 0-10). We also performed objective tests for evaluation of dry eye using a Schirmer test with anesthesia (basal tear secretion test), the tear film break-up time test, and fluorescein and rose bengal staining tests at 0, 28, and 56 days after treatment.
  
  
  RESULTS
  Fluorescein and rose bengal staining tests showed that there was a significant reduction in signs after occlusion using hypromellose. The symptoms measured by the visual scale were significantly reduced. The values of the Schirmer test with anesthesia and the break-up time test increased significantly. The effects persisted for up to 8 weeks. There were no dropouts or reported side effects during the 24-month follow-up.
  
  
  CONCLUSIONS
  Our results suggest that punctal occlusion using hypromellose 2% is a low-cost and safe additional treatment for dry eye.
authors.affiliation: *Hospital Universitário de Brasília, Universidade de Brasília (UnB), Brasília, Brazil; †Department of Ophthalmology, Universidade de Brasília UnB, Brasília, Brazil; and ‡Department of Internal Medicine, Universidade de Brasília (UnB), Brasília, Brazil.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Capita
authors.forename: Maria R
authors.initials: MR
authors.lastname: Chalita
authors.forename: Leopoldo Luiz
authors.initials: LL
authors.lastname: dos Santos-Neto
mesh_terms: D015352:Dry Eye Syndromes / Q000503:physiopathology / Q000628:therapy*; D005143:Eyelids; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D006801:Humans; D065347:Hypromellose Derivatives / Q000627:therapeutic use*; D007765:Lacrimal Apparatus / Q000187:drug effects* / Q000378:metabolism; D008297:Male; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D012395:Rose Bengal; D016037:Single-Blind Method; D013194:Staining and Labeling; D013666:Tears / Q000502:physiology
chemical_list: D005456:Fluorescent Dyes; D009883:Ophthalmic Solutions; D012395:Rose Bengal; D065347:Hypromellose Derivatives; D019793:Fluorescein