Trehalose in Dry Eye Drops

Thealoz Duo award

Trehalose in Dry Eye Drops

Trehalose in Eye Drops.

Patients often ask in our clinics, which are the best eye drop for dry eyes? There are a lot of drops and many treatments available, and the market is only increasing, further sub-dividing categories within the dry eye space. As we understand the processes and the causes of dry eye, more targeted, specific treatments are being developed.

It is definitely a challenge to find the best eye drops to treat dry eye. Patients jump from drop to drop hoping to find the cure. Unfortunately, as there as many reasons a patient suffers from dry eye are there are dry eye drops and treatments on the market, there is no one solution. You could go with the averages, 80% of patients with dry eye have evaporative dry eye, leaving the eye dehydrated and uncomfortable. Without going into the many causes of the evaporative issue, a replacement drop to provide what you are not providing is a good place to start. In the market dry eye drops are either aqueous based (tear film replacement/substitution), oil based (improve the tear quality) or a mixture of both. The majority of patients do not have any serious underlying conditions that leave them with dry eye symptoms irrespective of what they do, e.g. Sjogren syndrome.


It is pretty much accepted universally that eye drops with preservatives are in fact problematic in themselves. While not all preservatives are toxic to the eye manufacturers steer clear of using preservatives where possible and so should you.

Increased computer use and digital devices in general, compounded by our current restricted/indoor lifestyles are all contributing to the incidence of dry eye. Even wearing our face mask, deflecting a warm breath over our eyes has in itself increasing the incidence of dry eye. Patients will often comment when they switch to a new drop, it can be super effective initially, only to reduce in efficacy, leading to more frequent instillation and finally ineffective.

Dry eyes have many underlying reasons and thus finding a single drop to cure symptoms as they occur is probably not possible. When the underlying cause can be as varied as excessive use of digital devices, reduced blink rate, dry/air-conditioned environments, dietary intake of dehydrating agents, general lack of hydration, allergies, face-masks etc

Trehalose is a novel, naturally found sugar found in certain animals and plants, that has some unique properties. It is found abundantly in nature and protects plants from long periods of dehydration, protecting the plant from drying. Trehalose forms a cocoon type structure around the plant cells protecting them until the plant rehydrate and flourish once again. Trehalose has been introduced by Thea pharmaceuticals into its dry eye drops. Similarly it works by protecting cornea cells from desiccation and periods of high osmolarity by fortifying the epithelial cells on the front surface of the cornea and preventing them from denaturing in the absence of sufficient tear film.

Insufficient tears is the obvious reason someone has uncomfortable dry eyes, but when the cornea has dead epithelial cells on its surface the real discomfort begins. Our corneas are super sensitive due to the large number of densely packed nerve fibres. So while the white of our eye can look red and inflamed it actually causes very little discomfort, contrary to the cornea the sclera has very few nerve fibres. Hence you can touch the white of your eye without any great affect where as touching your cornea is a different matter.

Thealoz Duo Gel-2

Thealoz Duo Gel

Thealoz Duo eye drops are a preservative free eye drop with Trehalose as the active ingredient. It is the most widely used eye drop in Europe and one of our first “go to” drop in our clinics. It is recommended three times daily, and crucially every day, as distinct from days you are aware of the dryness. Trehalose crucially reduces the death of the front surface cells on your cornea allowing them to survive in the dry environment only to revive once dehydration is restored. Like the plant in the desert that looks dead only to revive and thrive when the rains come.

Thealoz duo comes in a thicker single unit formulation also which we advise patient who often wake during the night or early morning with an uncomfortable dry eye to instil into the bed before lights out