Features of the use of tear substitutes, depending on the release form, in the treatment of dry eye disease in patients with Parkinson’s disease

Parkinson’s disease is the second most common neurodegenerative disease in the elderly in the world. According to statistics, the number of people with Parkinson’s disease in 2030 will reach 10 million. Specific symptoms of parkinsonism such as tremors, bradykinesia, muscle stiffness affect the quality of life of these patients, and the ability to perform everyday manipulations. Necrosis of dopaminergic neurons in the substantia nigra, which is responsible for dopamine synthesis, leads to its reduced production, resulting in a decrease in blinking frequency, which is crucial for adequate moistening of the eye surface. Moreover, in patients with Parkinson’s disease, a number of biochemical processes cause specific changes in the state of the tear film, for example, in the structure of the meibomian gland secretion, which is the outer layer of the tear film, ensures the retention of tears on the eye surface and prevents the evaporation of its water component. Today, the treatment of dry eye disease is not always successful, even in patients without a history of comorbidities. The best results in reducing the manifestations of dry eye disease are achieved by prescribing tear substitutes. But given the main manifestations of Parkinson’s disease, the usual use of tear substitutes in the form of eye drops causes difficulties and requires external assistance. The search for new methods of treating dry eye disease and ways of administering tear substitutes is extremely urgent. The understanding that the diagnosis of Parkinson’s disease is irreversible and that patients with it will live long lives forces doctors of all specialties who have anything to do with the symptoms in such patients to make their lives as easy as possible and to make aging as comfortable as possible.