Dry eye syndrome is a chronic and progressive syndrome. It may also not be completely curable depending on the severity and cause. In some cases dry eye can be managed resulting in less dry eye symptoms, clearer eye vision and greater eye comfort. Since the causes of dry eye differ, different causes of action are taken to deal with it. An eye doctor can recommend one or a combination of remedies to deal with dry eye. Most eye doctors also administer a questionnaire to act as a survey. This is then used as a baseline in trying to find the appropriate remedy. The questionnaire may also be administered after a couple of weeks on a particular remedy to find out its effectivity.
List of dry eye treatments
This is ideal for mild cases of dry eye that is caused by sitting in front of a computer for too long or from reading for a while without taking a break. This is resolved by artificial tears or lubricating eye drops. There are a variety of artificial tears brands that can be bought over the counter without a prescription. The only challenge that arises is finding which formulation is ideal. Artificial tears that have a low viscosity are often light and watery and they offer quick relief without blurring ones vision. However, their effectivity is short lived and must be used every so often to get the eye relief one seeks. High viscosity artificial tears have long lasting benefits. Since they are gel-like they often blur eyesight for a while immediately after application. This type of artificial tears is not recommended when one is carrying out tasks as driving since it blurs eyesight. It is recommended for bedtime use. Ingredients incorporated in artificial tears determine which dry eye they are best suited for. For example some brands work best for dry eye associated with aqueous-deficiency while others are best for evaporative dry eye. It is important to follow the doctor’s advice to the letter on the application of artificial tears especially when using more than one remedy.
This is a prescription dry eye treatment. Restasis- Allergan- not only lubricates the surface of the eye but also has an agent that works to reduce the inflammation normally caused by dry eyes and helps the eye produce its own natural tears to lubricate it while keeping the eye healthy. One should also note that the therapeutic effect of Restasis is not immediate and must be used for about 90 days for one to experience the maximum benefits. Some people tend to experience a burning sensation the first weeks of using Restasis before the eye gets used to it.
Shire received approval from the FDA in July 2016 to market its new prescription dry eye treatment in the United States. Xiidra, like Restasis aimed at reducing eye inflammation associated with dry eye. Research on safety and efficacy of Xiidra was studied in four placebo controlled 12 week clinical trials that had 1181 participants with dry eye. These participants were reviewed prior to starting treatment, then after 2 weeks, 6 six and 12 weeks of Xiidra use. Participants in the study noticed a significant reduction in dry eye symptoms after using Xiidra for the first two weeks. The use of Xiidra did not go without any noted side effects; the most common were altered taste sensations, eye irritation and reduced visual acuity. The ideal dosage for Xiidra is two applications per eye per day ideally 12 hours apart, say morning and evening.
Steroid eye drops
Inflammation one of the major effects of dry eye is frequently associated with the redness and burning sensation common in dry eye disease. Artificial tears do not adequately resolve the inflammation problem and steroid eye drops may be recommended to resolve it. Steroid eye drops are used at a short term basis. It is often used with artificial tears or Restasis as a compliment for long term treatment of dry eye inflammation. While the steroids may be absorbed by the eye, the effect is not seen beyond this. Most doctors prefer to start treatment with a mild steroid that can be quickly degraded by the eyes then increase the dosage in accordance with the severity of the dry eye symptoms. The side effects associated with steroid eye drops include increased eye pressure and cataracts if used for extended time frames.
Lacrisert (Bausch + Lomb)
This is a sterile slow release lubricant that is placed on the inferior cul-de-sac of the eye which is under the lower eye where the conjunctiva in the inside of the eye meets the one on the eyeball. Lacrisert contains hydroxypropyl cellulose which is a preservative free lubricating agent which liquefies over time creating a moisturized environment all day long. Lacrisert is applied once a day and is known to relief dryness, itchiness, watery eyes, foreign body sensation blurred vision and light sensitivity. It works for people who have severe dry eye, especially where artificial tears alone have failed to resolve the dry eye. One should note that the improper application of Lacrisert on the inferior cu-de-sac of the eye could lead to corneal abrasion. Other side effects of Lacrisert include; light sensitivity, transient blurred vision, eye irritation, red eyes, matting and stickiness of the eyelashes.
This is used to help tears remain on the eye surface longer. The Punctal plug is a small device that is sterile. It is inserted in the Puncta of the tear drainage ducts in the inner corner of the upper and lower eye lids. When the plugging is done, it ensures that tears can no longer drain away from these ducts and the tear film stays intact longer. The tears will naturally evaporate from the eye without any additional symptoms. However, if the plugs cause watery eyes, then one of the plugs can be removed.
Meibomian gland expression
A huge percentage of dry eyes are caused by inadequate secretion of meibum from the Meibomian glands located in the eyelid margins. These glands are found in the base of the eyelash. If these openings get clogged the oil-meibum- which works to keep the tear film from evaporating to quickly cannot sufficiently do its job. This condition is known as Meibomian gland dysfunction which causes a condition known as evaporative dry eye. Doctors treat evaporative dry eye and MGD in an in-office procedure known as Meibomian gland expression. Warm compresses are applied to the eyelids, and then a pair of forceps is used to squeeze the clogged contents which are usually hardened meibum and dirt from the Meibomian glands. This is a very uncomfortable procedure as a considerable amount of pressure id placed upon the eyelids, but is very effective in the long haul.
This is considered a more comfortable approach to unblocking clogged Meibomian glands. Warm compresses are simply applied to the eyelids to soften the hardened meibum. For these compresses to work according to researchers the compresses must maintain a temperature of 108 degrees Fahrenheit for a minimum of 10 minutes and this has to be done twice a day. Most people are not capable of applying this treatment as required, and it is also quite hard to maintain the temperature for the recommended time frame and is hence rendered ineffective.
The LipiFlow Thermal Pulsation System-tear science is an automated in office dry eye treatment that uses the warm compresses therapy in conjunction with Meibomian gland expression. The device is made to fit over the eyelids and applies precisely controlled heat to soften hardened meibum. This system applies pressure to the eyelids to open and express clogged glands and in the long run restoring the correct balance of oils in the tear film to relieve dry eye. This treatment takes about 12 minutes per eye. In a clinical study to check the effectiveness of this treatment, 76 percent of the participants reported improvement in their dry eye symptoms within two weeks as the tear film lasted longer before evaporating. The treatment last for 1 to 3 years. Its side effects include; corneal abrasion, eye pain, swollen eyelids, eyelid irritation, inflammation of the eyelids and transient blurred eye vision including red itchy eyes.
Intense pulsed light
The FDA approved the use of intense plugged light over a decade ago to treat rosacea on the skin. Ocular rosacea presents with small dilated blood vessels coursing along the eyelash margins in patients suffering from blepharitis which contributes to dry eye. In this treatment a handheld device flashes light with wavelengths that can be absorbed by these blood vessels. This leads to the resolution of dilated blood vessels and associated inflammation. This treatment brings relief too many patients and reduces dependence on artificial tears. It is ideal for patients who do not want to go through the hustle of dealing with eye drops. The treatments are usually done four to six times with about a month’s treatment between each break.
Nutritional supplements. Supplements with omega-3 fatty acids reduce dry eye. The sources include cold water fish like salmon, sardines, herring and cod. For vegetarians, flaxseed oil works. Drinking more water also reduces the severity of dry eye.
- Blink frequently. It is important to remember to blink more when using digital devices like computers.
- Take frequent breaks from computer use. Take a look away from the computer every 20 minutes.
- Remove eye makeup thoroughly. Eye makeup can clog Meibomian glands if not thoroughly removed.
- Clean your eyelids. Before going to bed it is of essence to clean eyelids to remove any bacteria that may cause blepharitis and Meibomian gland problems.
- Wear quality sunglasses. When outdoors, it is important to wear sunglasses that block out the sun’s UV rays. Ideally get glasses with a wrap that can block dust and other particles.
Featured image source: DepositPhotos/AndreyPopov