Sodium hyaluronate

How it works

Its high molecular weight and water-binding capacity allow it to retain moisture on the ocular surface and form a stable, viscoelastic protective film over the cornea and conjunctiva.

Prescribing in practice

• Many lubricant formulations are preservative-free or contain preservatives that can cause ocular surface toxicity with frequent or long-term use, so a preservative-free product is preferred for chronic dosing or in preservative-sensitive patients.
• May be instilled as often as required for symptom relief and is generally well tolerated.
• If multiple eye drops are used, separate instillation of different drops and apply ointments last.

Monitoring

No systemic monitoring is required; review symptom control and ocular surface health clinically and reassess if irritation or worsening symptoms occur.

Counselling the patient

• Transient blurring of vision may occur immediately after instillation, so wait until vision clears before driving.
• Remove soft contact lenses before instilling unless the product is specifically licensed for use with lenses, and follow the manufacturer's discard date once opened.

Evidence & guidelines

Ocular lubricants are recommended as first-line therapy for dry eye disease in clinical guidance such as NICE Clinical Knowledge Summaries.