Dry eye can impact your quality of life
Dry Eye symptoms can make it more difficult to perform your regular daily activities. 1
Driving, especially at night
Working on a computer or a mobile device (e.g., cellular phones and tablets)
Remember, even if your Dry Eye symptoms are mild and don’t bother you all the time, you should talk to your optometrist of ophthalmologist because symptoms can worsen over time if you don’t treat them. 1
Why should I talk to my optometrist or ophthalmologist about Dry Eye?
It is always a good idea to talk to an optometrist or ophthalmologist about any problems you may be experiencing with your eyes. They can provide relief with over-the-counter medications or prescription medications.
In addition to discussing the Dry Eye symptoms you may be experiencing, your optometrist or ophthalmologist may perform some tests to screen your eyes for signs of Dry Eye. Two common tests are: 2
- Tear Break-Up Time (TBUT)
- Fluorescein Staining
- Decreased quality of vision
- Increased risk of eye infections
What are my treatment options?
If your optometrist or ophthalmologist has determined that you have Dry Eye, he or she will assess the severity based on signs and symptoms. This will help determine the most effective treatment option. Depending on the severity of your Dry Eye symptoms, which can range from mildly irritating to severely disabling, treatment may be geared towards symptom relief, improving vision, enhancing quality of life, slowing progression, restoring tear production, or correcting the issue that is causing Dry Eye. 1, 2 The following outline the four possible categories of treatment options.
- Avoid exposure to allergens
- Avoid hot, windy, low-humidity and high-altitude environments
- Get an adequate amount of sleep and drink plenty of water
- Quit smoking and or avoid being around tobacco smoke
- Limit the amount of time you spend on activities that reduce blinking (e.g., watching TV, reading, or computer use)
- Adopt a diet rich in omega-3 fatty acids (fish and fish oils, canola oil, flax seeds and flax seed oil, walnuts and walnut oil); they may reduce the inflammation associated with Dry Eye Disease. 3
Over-the-Counter (OTC) Eye Drops
Tear supplements, or artificial tears, can be purchased without a prescription to lubricate the surface of the eye.. They provide temporary relief of Dry Eye symptoms by “replacing” some of the lubrication that tears provide, which the eyes are not producing. Tear supplements may be an option for many Dry Eye sufferers and can be used on daily as you need relief. They are available as liquid drops, gels, or ointments. These over-the-counter medications are for short-term relief of symptoms and do not stop the progression of Dry Eye. 1, 2
When Dry Eye symptoms are not relieved with the use of artificial tears or you are using artificial tears more than 4 times a day, it is time to talk to your optometrist or ophthalmologist about other options, including anti-inflammatory treatments. Inflammation is thought to be a key reason why Dry Eye develops (see the video here for more information). Prescriptions that are used to treat Dry Eye include: 1, 2
- Secretagogues (short-term)
- Corticosteroids (long-term)
- Cyclosporine ophthalmic emulsion (long-term)
Secretagogues are prescribed to people with Sjögren’s syndrome, an autoimmune disorder that attacks the tear and saliva glands, causing eye and mouth dryness. Secretagogues help create tears and saliva. 1, 2 Adverse effects include sweating, nausea, and intestinal cramping. 2
Corticosteroids can help relieve chronic Dry Eye, however, long-term use is limited due to adverse effects such as cataracts, immunosuppression, and the potential for increased intraocular pressure (pressure in the eye). Corticosteroids are also used to ease a person into long-term anti-inflammatory treatment options, primarily topical cyclosporine (see below). 4
Cyclosporine ophthalmic emulsion increases a patient’s own natural tear production by directly treating the underlying inflammation. Cyclosporine A is recommended for patients with moderate to moderately severe Dry Eye symptoms. Patients may feel temporary burning when they use cyclosporine however, this side effects improves over time. 2
- Punctal closure (punctal plugs): a small device that is inserted into the opening of the tear duct in order to block the duct and prevent tears from draining into the nose; this closure can be made permanent through cauterization of the puncta
- Conjunctival procedures: Gunderson flap, conjunctival transplantation, amniotic membrane transplant, free conjunctival graft, and stem cell replacement
|Treatment Options||Benefits Of Treatment 1, 2 (Other Than Dry Eye Symptom Relief)|
|Short-term Symptom Relief||Long-term Symptom Relief||Safe For Long-term Use||Treats The Inflammation That Causes Dry Eye||Restores Healthy Tear Production||Lubricates the Surface Of Your Eyes||Other|
|Cyclosporin A||√ 5||√ 5||√||√||√|
|Punctal Plugs *|
|Removable||√||√||Block Tear Drainage To Keep Eyes Moist|
|Dissolvable||√||Block Tear Drainage To Keep Eyes Moist|
|Permanent Punctal Closure †||√||√
Can Be Reversed
|Blocks Tear Drainage To Keep Eyes Moist|
|Essential Fatty Acids|
* Punctal plugs are tiny devices that are inserted into tear ducts to block drainage and increase the moisture on dry eyes.
† Permanent punctual closure is a procedure that closes the tear ducts with a heat or laser procedure.
- The Tear Film & Ocular Surface Society. Rapport 2007 du Dry Eye WorkShop (DEWS) international. Numéro spécial. The Ocular Surface 2007;5(2):67–204.
- Jackson WB. Management of dysfunctional tear syndrome. Can J Ophthalmol 2009;44(4):385–394.
- Miljanovic B, Trivedi KA, Dana MR, et al. Relation between dietary n-3 and n-6 fatty acids and clinically diagnosed dry eye syndrome in women. Am J Clin Nutr. 2005;82:887–93.
- Prokopich CL, Bitton E, Caffery B, et al. Screening, Diagnosis and Management of Dry Eye Disease: Practical Guidelines for Canadian Optometrists. Can J Optomet 2014;7(Suppl 1.):3-31.
- Rao SN. Reversibility of dry eye deceleration after topical cyclosporine 0.05% withdrawal. Journal of Ocular Pharmacology and Therapeutics. 2011;27(6):603–609.