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Dry Eye Treatment | What Options Are Available?

Several treatment options are available to treat dry eyes. Individuals can also make certain lifestyle changes that may decrease, reduce, or eliminate dry eyes altogether.

According to data gathered from the National Health and Wellness Survey, 6.8% of adults in the United States (which represents about 16.4 million people) have been diagnosed with dry eye disease. Various factors may trigger the condition.

Factors to Consider Before Selecting Treatment 

The most important factor to consider is the severity of your dry eye symptoms. For instance, if you experience a minimal amount of discomfort and slight redness, you may be able to simply make certain lifestyle changes that will rid you of the problem.

Conversely, if you find stringy mucus in or around the eyes, eye crust that makes it hard to open your eyes when you wake up in the morning, or difficulty wearing contact lenses, it’s time to see an experienced eye doctor to go over your treatment options.

Other symptoms that may require medical treatment include the following:

  • Light sensitivity
  • Feeling like you have something stuck in your eye
  • Difficulty driving at night
  • Excessively watery eyes

Selecting the right treatment for dry eye syndrome depends on the severity of symptoms as well as your individual needs.

Chronic Dry Eye Syndrome

It’s important to differentiate between an isolated occurrence and a chronic condition. If you have never experienced dry eyes or dry eye syndrome before, it’s likely that making a change in diet, screen viewing habits, sleep schedule, or other lifestyle habits will rectify the issue.

However, if you’ve experienced dry eyes before or for extended periods of time, you may have a chronic condition that will require treatment from an eye care professional. 

For Less Severe Dry Eye Symptoms

In many cases, dry eye can be alleviated with eye drops (also called artificial tears). This is actually a good first method of treating dry eyes. If you find artificial tears to be effective in treating your dry eye symptoms, medical treatment may not be necessary. 

You can buy artificial tears at many retailers without a prescription from your eye doctor. Additionally, over-the-counter moisturizing gels as well as certain eye ointments may help to get rid of your dry eye symptoms without having to see an ophthalmologist.

When to See an Eye Doctor or Medical Professional

If your dry eye syndrome is on the more severe side, it’s important to see an eye doctor as soon as possible. Your eye doctor should be able to diagnose the underlying issue, especially if your dry eyes are caused by underlying vision problems.

However, if your dry eyes are the result of an underlying medical condition, such as rheumatoid arthritis, it’s important to see a medical practitioner who can help you address the underlying problem as soon as possible. In many cases, treating the underlying medical condition will reduce or eliminate your dry eye symptoms. 

If dry eyes are affecting your vision and day-to-day functionality, it’s time to see an eye care professional promptly.

How Do Doctors Diagnose Dry Eyes?

At your appointment, your eye doctor may perform a variety of tests and procedures. These tests and procedures will help determine the cause of the problem. Here are some to expect: 

Comprehensive Eye Exam

First, your eye doctor will perform a comprehensive eye exam. They will cover your overall health history as well as your eye health. This will help you and your eye doctor determine the severity of the problem, its underlying cause, as well as if the condition is getting better or worse.

Moisture Volume Tests

Next, your eye doctor will likely conduct a test that will measure the volume of moisture in your eyes, which is  the volume of tears your eyes are producing. Most often, eye doctors utilize a Schirmer tear test with blotting strips that are placed underneath the lower eyelids. This test will take around five minutes to conduct. 

Another test often used is called the phenol red thread test, which measures tear volume.

Testing Tear Quality

Your eye doctor will likely conduct tests in order to determine tear quality. Special dyes can be used in eye drops to better understand your eye surface condition. An eye doctor looks for staining patterns that occur on the corneas of the eye, measuring the length of time it takes for tears to evaporate. 

Tear osmolarity tests may also be used in order to determine the composition of particles and water in your tears. Elevated matrix metalloproteinase-9 or decreased lactoferrin are both common among those who suffer from dry eye syndrome.

What Are the Various Treatment Options for Dry Eye? 

Dry eye disease treatment can be broken down into mild cases and severe cases, as mentioned above.

Mild Cases

Mild cases of dry eye can be treated with artificial tears. Many cases of dry eye can be reduced or eliminated with regular use of artificial tears. For more severe and serious symptoms, medication or surgery may be necessary.

More Severe Cases

Medication and specialized treatments are often necessary for more severe cases of dry eye syndrome. Treatments and medications related to dry eye syndrome tend to focus on reversing the condition or managing symptoms.

Medications for Dry Eye

Medication for treating dry eye syndrome may be geared toward reducing inflammation, which can result in blockages in your oil glands. Antibiotics are also often used, which help to reduce inflammation of the eyelids. Antibiotics are available orally as well as in prescription eye drops and prescription ointments.

Eye inserts are another treatment option that works in the same way as artificial tears, except eye inserts can help conditions that over-the-counter eye drops cannot. Hydroxypropyl cellulose (Lacrisert) inserts can be placed between the lower eyelid and the eyeball. This kind of insert has slow-dissolving properties, which release a substance that lubricates the eye.

Tear-stimulating medicines are also available. Cholinergics (pilocarpine and cevimeline) can help to effectively increase tear production. Tear-stimulating medicines come as pills, gels, and eye drops. 

Alternative Procedures for Dry Eyes

Certain medical procedures and treatment strategies for dry eye are also available. 

Closing tear ducts can often help to reduce tear loss. If tears are leaving the eyes too quickly, this is an effective procedure. Partially (or completely) closing your tear ducts will reduce tear draining.

Another procedure involves tear duct plugs, which are made of silicone (also called punctal plugs). Tear duct plugs are removable. 

Tear ducts can also be plugged with a procedure that utilizes targeted heat, which is a more permanent solution called thermal cautery.

Unblocking oil glands may help. This is usually done with warm compresses or eye masks. Compresses or eye masks are generally used on a daily basis and have been shown to help clear blocked oil glands. Thermal pulsation devices can also be used to unclog your oil glands. 

Light therapy and eyelid massage are sometimes recommended as additional treatments for dry eye syndrome. 

References

Dry Eye Disease. (February 2023). UpToDate.  

​​Dry Eye Disease: Risk Factors and Selecting Treatment. (October 2015). The Pharmaceutical Journal. 

Dry Eye Disease: When to Treat and When to Refer. (October 2018). Australian Prescriber. 

Advances in the Diagnosis and Treatment of Dry Eye. (September 2020). Progress in Retinal and Eye Research. 

Advances in Dry Eye Disease Treatment. (May 2019). Current Opinion in Ophthalmology

The Pathophysiology, Diagnosis, and Treatment of Dry Eye Disease. (January 2015). Deutsches Ärzteblatt International.
Current Management and Treatment of Dry Eye Disease. (December 2018). Turkish Journal of Ophthalmology.

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