Dry Eye syndrome
Dry Eye Treatment
Dry eye syndrome is a chronic and typically progressive condition. Depending on its cause and severity, it may not be completely curable.
But in most cases, dry eyes can be managed successfully, usually resulting in noticeably greater eye comfort, fewer dry eye symptoms, and sometimes sharper vision.
Successful treatment of dry eyes requires that you are willing to follow your eye doctor's recommendations and that you use the products he or she recommends consistently and as frequently as directed.
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1. Artificial tears
For mild cases of dry eyes caused by computer use, reading, schoolwork and other situational causes, the best dry eye treatment may simply be frequent use of artificial tears or other lubricating eye drops.
Artificial tears usually are the first step in dry eye treatment.
Instead of OTC artificial tears (or in addition to them), your eye doctor might recommend daily use of a prescription eye drop called Restasis (Allergan) for your dry eye treatment.
Restasis does more than simply lubricate the surface of your eye. It includes an agent that reduces inflammation associated with dry eye syndrome and helps your body produce more natural tears to keep your eyes moist, comfortable and healthy.
It's important to know, however, that the therapeutic effect of Restasis is not immediate. You must use the drops daily for a minimum of 90 days to experience the full benefits of this dry eye treatment.
Xiidra (ZYE-druh) is another prescription eye drop for dry eye treatment.
Xiidra (Shire), like Restasis, is aimed at reducing inflammation associated with the signs and symptoms of dry eyes.
4. Steroid eye drops
Steroid eye drops generally are used short-term to quickly manage symptoms. They often are used in conjunction with artificial tears and Restasis or Xiidra, as a complement to these more long-term dry eye treatment strategies.
Steroid eye drops (especially if used for relatively long periods) have the potential of causing side effects. So, it's important to make your eye doctor aware of your full medical history before starting steroid eye drops.
Lacrisert (Bausch + Lomb) is a sterile, slow-release lubricant that is placed under the lower eye lid where the conjunctiva of the inside of the eyelid meets the conjunctiva of the eyeball.
6. Punctal plugs
A punctal plug is a small, sterile device that is inserted into one of the small openings (puncta) of tear drainage ducts that are located in the inner corner of the upper and lower eyelids.
After these openings have been plugged, tears can no longer drain away from the eye through these ducts. This results in the tear film remaining intact longer on the surface of the eye, relieving dry eye symptoms.
So where do the tears go? Usually they will simply evaporate from the eye surface without symptoms. But if insertion of punctal plugs causes watery eyes, one or more of the plugs can be removed.
7. Meibomian gland expression
A very significant percentage of dry eye cases are caused by inadequate oil (meibum) being secreted from meibomian glands located along the margin of the eyelids.
The openings of these glands are near the base of the eyelashes. If these openings get clogged, the oil that's critical to keeping the tear film from evaporating too quickly cannot do its job. This is called meibomian gland dysfunction (MGD), which is a significant cause of evaporative dry eye symptoms.
To treat MGD and evaporative dry eye, your eye doctor may perform an in-office procedure called meibomian gland expression. In this procedure, warm compresses may or may not first be applied to your eyelids; then a forceps-type device is used to squeeze the clogged contents (hardened meibum and possibly other substances) from the meibomian glands.
To fully express the contents of the meibomian glands and get them functioning properly, significant pressure must be applied to the eyelids, which can be uncomfortable. But the results usually make any short-term discomfort from the procedure worth it.
8. Warm compresses
An alternative (and potentially more comfortable) way to help open clogged meibomian glands to treat dry eyes is to simply apply warm compresses to the closed eyelids to soften the hardened meibum.
Unfortunately, for warm compresses to work well, some researchers say you have to use a compress that can maintain a temperature of 108 degrees Fahrenheit for more than 10 minutes, and the compresses have to be applied for this length of time at least twice a day.
Most people are unable or unwilling to perform this type of dry eye treatment correctly, and shorter and less frequent use of variable-temperature warm compresses typically is ineffective.
The LipiFlow Thermal Pulsation System (TearScience) is an automated, in-office dry eye treatment that combines the best features of warm compress therapy and meibomian gland expression.
10. Intense pulsed light
For well over a decade, the FDA has approved the use of intense pulsed light (IPL) to treat rosacea on the skin. Rosacea on the skin and eyelid often occur together.
In IPL treatment, a hand-held device flashes bright light onto the skin. The light is filtered to allow only wavelengths that can be absorbed by the dilated blood vessels. The effect of this treatment may be the resolution of the dilated vessels and associated inflammation that contributes to dry eye symptoms.
Many patients experience relief from their dry eye symptoms after IPL and become less dependent on artificial tears and other routine measures to keep their eyes comfortable. For this reason, IPL treatment may be well-suited for dry eye patients who don't want to be troubled by the inconvenience of frequent eye drop use.
Patients usually require four to six monthly IPL treatments for optimum effects. Typically, the treatments are well-tolerated and are not associated with any down-time. However, it's important to discuss with your doctor how much time you spend in the sun, as the treatments will make your eyelids more light-sensitive.
IPL treatment generally is not covered by health insurance or vision insurance and it may not be appropriate for patients with certain skin pigmentations.
11. Nutritional supplements
Doctors sometimes recommend nutritional supplements as part of a holistic dry eye treatment plan.
Studies have found that supplements containing omega-3 fatty acids can decrease dry eye symptoms. Good sources of omega-3s include cold-water fish such as salmon, sardines, herring and cod. For a vegetarian source of omega-3s, some eye doctors recommend flaxseed oil to relieve dry eye.
Also, simply drinking more water might help relieve dry eye symptoms. Mild dehydration often makes dry eye problems worse. This is especially true during hot, dry and windy weather.
12. Home remedies for dry eyes
If you have mild dry eye symptoms, there are several things you can try to get relief before going to the eye doctor:
Blink more frequently. Research has shown that people tend to blink much less frequently than normal when viewing a computer, smartphone or other digital display. This decreased blink rate can cause or worsen dry eye symptoms. Make a conscious effort to blink more often when using these devices. Also, perform full blinks — gently squeezing your eyelids together — to fully spread a fresh layer of tears over your eyes.