Dry Eye Syndrome Treatment
Treatment
General measures
Dry eyes can be exacerbated by smokey environments, dust and air conditioning, and by our natural tendency to reduce our blink rate when concentrating. Purposefully blinking, especially during computer use and resting tired eyes are basic steps that can be taken to minimize discomfort. Rubbing one's eyes can irritate them further, so should be avoided . Conditions such as blepharitis can often coexist and paying particular attention to cleaning the eyelids morning and night with mild shampoos and warm compresses can improve both conditions.
Environmental control
Dry, drafty environments and those with smoke and dust should be avoided. This includes avoiding hair dryers, heaters, air conditioners or fans, especially when these devices are directed toward the eyes. Wearing glasses or directing gaze downward, for example, by lowering computer screens can be helpful to protect the eyes when aggravating environmental factors cannot be avoided . Using a humidifier, especially in the winter, can help by adding moisture to the dry indoor air.
Artificial tears
For mild and moderate cases, supplemental lubrication is the most important part of treatment. Application of artificial tears at least 4 to 6 times per day can provide temporary relief. Recommended brands of over-the-counter eyes drops for these purposes include:
- Optive
- Systaine
- Refresh tears
- Soothe
- Genteal
- Thera tears
Additional options
Lubricating tear ointments, such as Genteal gel and Refresh Celuvisc, can be used during the day, but they generally are used at bedtime due to poor vision after application. Application requires pulling down the eyelid and applying a small amount inside. Depending on the severity of the condition, it may be applied from every hour to just at bedtime. It should not be used with contact lenses.
Omega 3s
Consumption of dark fleshed fish containing dietary omega-3 fatty acids is associated with a decreased incidence of dry eyes syndrome. Alternatively, dietary supplements of Lifeguard Omega Eye capsules can be taken daily to provide the recommended intake necessary to relieve dry eye. The recommended dosage is 2 capsules twice a day.
Restasis
Topical cyclosporine A is an immunosuppressant that decreases surface inflammation. Usually, 1 drop of Restasis is instilled in each eye twice a day, 12 hours apart. It should not be used while wearing contact lenses, during eye infections, or in people with a history of herpes virus infections. Side effects include burning sensation, redness, discharge, watery eyes, eye pain, foreign body sensation, itching, stinging, and blurred vision. In order to minimize these side effects, a mild steroid drop, such as Lotemax is prescribed at the start of Restatsis treatment. The effects of Restasis on dry eyes do not occur immediately, but an overall relief in dry eye symptoms most often achieve best results 3 to 6 months after the beginning of Restasis treatment.
Punctal plugs
In each eye, there are little openings that drain tears into the tear ducts called puncta. There are methods to partially or completely close the tear ducts. This blocks the flow of tears into the nose, and thus more tears are available to the eyes. Punctal plugs are inserted into the puncta to block tear drainage, mainly for or people who have not found dry eye relief with drugs, punctal plugs may help. They are reserved for people with moderate or severe dry eye when other medical treatment has not been adequate.
If punctal plugs are effective, surgical cauterization of puncti can be performed. This shrinks the drainage area, and thus closes the tear duct.
Customized contact lenses
Persons with severe dry eyes may benefit from the Boston Scleral Lens, which is a customized contact lens. Resting on the sclera, it creates a fluid filled layer over the cornea, thus preventing it from drying.
Prognosis
Dry eye syndrome usually is a chronic problem, and its prognosis shows considerable variance, depending upon the severity of the condition. When dry eyes symptoms are severe, they can interfere with quality of life. People sometimes feel their vision blurs with use, or have severe irritation to the point that they have trouble keeping their eyes open and may not be able to work or drive. Most patients have mild-to-moderate cases, and can be treated symptomatically with lubricants, and provides an adequate relief of symptoms.
The previous information is based on a current review of the literature and it is updated on a regular basis. We tailor our treatment plan to each individual.