Dry eye syndrome is a chronic and normally progressive condition. Depending on its cause and seriousness, it might not be totally treatable. However for the most parts, dry eyes can be managed effectively, generally leading to noticeably higher eye comfort, fewer dry eye symptoms, and in some cases sharper vision also.
Due to the fact that dry eye disease can have a number of causes, a range of treatment approaches are used.
The following is a list of dry eye treatments that are typically used by optometrist to minimize the symptoms and signs of dry eyes. Your eye doctor may suggest just one of these dry eye treatments or a mix of treatments, depending on the cause( s) and severity of your condition.
Also, some optometrist will have you finish a survey about your symptoms prior to initiating dry eye treatment. Your answers to this survey are then used as a baseline, and the survey may be administered again after a number of weeks of treatment to examine the effectiveness of the chosen treatment approach. If you haven’t established an eye doctor, click here to discover one near you.
Effective treatment of dry eyes needs that you want to follow your doctor’s recommendations and that you use the products she or he recommends regularly and as regularly as directed.
Some treatments concentrate on reversing or managing a condition or element that’s triggering your dry eyes. Other treatments can enhance your tear quality or stop your tears from quickly receding from your eyes.
Dry Eye Syndrome Treatment
1. Artificial Tears
For mild cases of dry eyes triggered by computer use, reading, schoolwork and other situational causes, the best dry eye treatment might just be regular use of synthetic tears or other lubricating eye drops.
There are numerous brand names of synthetic tears that are available without a prescription. The difficulty with using artificial tears is not absence of product accessibility– it’s the complicated number of brands and formulas available to pick from.
Synthetic tears and other over the counter (OTC) lubricating eye drops are offered in a wide array of components and viscosity (” thickness”).
Artificial tears with low viscosity are “light” and watery. They typically supply fast relief with little or no blurring of your vision when you use them. But often their relaxing result is very short-term, and often you should use these drops extremely regularly to get sufficient dry eye relief.
On the other hand, artificial tears that have a high viscosity are more gel-like and can provide longer-lasting lubrication. However usually these drops cause substantial blurring of your vision for several minutes instantly after you apply them. For this factor, these drops frequently are not an excellent option for use during your work day or when you need immediate clear vision for jobs such as driving. Rather, high-viscosity artificial tears are advised only for bedtime use.
Also, the components in certain brands of artificial tears may figure out which kind of dry eye condition they are better suited for. For example, one brand might work much better for aqueous-deficiency dry eyes, while another brand may be more effective for an evaporative dry eye condition.
If your optometrist suggests that you use several brands or formulations of artificial tears, make sure to follow the directions he or she offers you concerning when and how frequently you use the drops. Likewise, do not replace various brands from those your eye doctor recommends. Using a different brand or numerous brands of artificial tears will make it hard to evaluate the success of the dry eye treatment your doctor advised.
Rather of OTC synthetic tears (or in addition to them), your optometrist might recommend daily use of a prescription eye drop called Restasis (Allergan) for your dry eye treatment.
Restasis does more than simply lube the surface of your eye. It consists of an agent that lowers swelling related to dry eye syndrome and helps your body produce more natural tears to keep your eyes moist, comfortable and healthy.
It’s important to understand, nevertheless, 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 advantages of this dry eye treatment.
A considerable portion of individuals who try Restasis will experience burning eyes early during the first few weeks of treatment.
In July 2016, Shire revealed it got FDA approval to market its brand-new Xiidra (ZYE-druh) prescription eye drops for the treatment of dry eye in the United States.
Xiidra, like Restasis, is focused on reducing inflammation that is related to the symptoms and signs of dry eyes.
The safety and efficacy of Xiidra was studied in 4 placebo-controlled, 12-week scientific trials that included 1,181 people with dry eyes. Participants were assessed for dry eye signs and symptoms simply prior to beginning use of the drops, then after two weeks, six weeks and 12 weeks of Xiidra use.
In two of the 4 research studies, participants observed a significant decrease in dry eye symptoms after utilizing Xiidra for two weeks. In all 4 studies, participants observed a larger reduction in dryness symptoms after six weeks and 12 weeks of Xiidra use.
Also, at 12 weeks, a statistically significant reduction in signs of dry eyes was found among Xiidra users compared with individuals provided a placebo in two of the 4 studies.
The most typical side effects of Xiidra reported in the studies were eye inflammation, modified taste sensation and minimized visual skill, which took place in 5 to 25 percent of individuals.
The recommended dose for Xiidra, like Restasis, is two applications in each eye daily, around 12 hours apart.
4. Steroid Eye Drops
Over the past several years, medical professionals have actually found the significance of swelling as a cause of dry eyes. Swelling regularly causes the soreness and burning associated with dry eye disease; but in most cases, it may exist with no visible signs or symptoms at all.
Synthetic tears generally do not properly resolve these inflammatory modifications, and your doctor may suggest steroid eye drops to much better handle the underlying swelling associated with dry eyes.
Steroid eye drops are typically used short-term to quickly manage symptoms. They are frequently used in conjunction with artificial tears and Restasis, as a complement to these more long-lasting treatment methods.
While a percentage of the steroid might get soaked up systemically, in the right candidate, the results of steroid eye drops are usually not noticed beyond the eye. Still, it’s important to discuss your medical history with your optometrist prior to beginning steroid eye drops.
Various types of steroid drops are readily available and vary in their potency. Most physicians prefer to begin with mild steroids that are quickly broken down inside the eye. Sometimes, nevertheless, more potent drops are needed to attend to more severe symptoms.
Steroid eye drops can increase the risk of establishing high eye pressure and even cataracts if used for prolonged time periods. But these dangers are low when the drops are used just on a short-term basis for dry eye treatment.
Lacrisert (Bausch + Lomb) is a sterilized, slow-release lubricant that is placed under the lower eye where the conjunctiva of the inside of the eyelid satisfies the conjunctiva of the eyeball (this area is called the inferior cul-de-sac of the eye).
Lacrisert is a solid insert made up of a preservative-free lubricating representative (hydroxypropyl cellulose) that slowly melts in time, offering an all-day moistening impact.
For the majority of people with dry eyes, a single Lacrisert is applied once a day. The device has actually been shown to relieve dryness, burning, watery eyes, foreign body feeling, itching, light sensitivity and blurred vision, inning accordance with the company.
Lacrisert generally is recommended for patients with moderate to severe dry eye symptoms, particularly if dry eye treatment with synthetic tears alone shows unsuccessful.
If improperly placed in the inferior cul-de-sac of the eye, it’s possible Lacrisert could cause a corneal abrasion. Also, Lacrisert may cause transient blurred vision, eye discomfort or inflammation, matting or stickiness of eyelashes, red eyes and level of sensitivity to light.
6. Punctal Plugs
Punctal plugs are often used in dry eye treatment to assist tears stay on the surface of the eye longer.
A punctal plug is a little, sterile device that is inserted into among the little openings (puncta) of tear drainage ducts that lie in the inner corner of the upper and lower eyelids.
After these openings have actually been plugged, tears can no longer drain away from the eye through these ducts. In this method the tear film stays undamaged longer on the surface of the eye, relieving dry eye symptoms.
So where do the tears go? Normally they will just vaporize from the eye surface area without symptoms. But if insertion of punctal plugs causes the eyes to “water,” one or more of the plugs can be gotten rid of.
7. Meibomian Gland Expression
An extremely considerable portion of dry eye cases are triggered by inadequate oil (meibum) being produced from meibomian glands located along the margin of the eyelids.
The openings of these glands are near the base of the eyelashes, and if these openings get clogged, the oil that is important to keeping the tear movie from vaporizing too rapidly can not do its job. This is called meibomian gland dysfunction (MGD), which results in a condition called evaporative dry eye.
To treat MGD and evaporative dry eye, your eye doctor might carry out an in-office procedure called meibomian gland expression. In this procedure, warm compresses might or may not first be applied to your eyelids; then a forceps-type device is used to squeeze the clogged contents (hardened meibum and potentially other substances) from the meibomian glands.
To fully express the contents of the meibomian glands and get them working effectively, considerable pressure should be used to the eyelids, which can be uncomfortable. However the results normally are worth putting up with the short-term discomfort of the procedure.
8. Warm Compresses
An alternative (and possibly more comfortable) way to assist open clogged meibomian glands to treat dry eyes is to simply apply warm compresses to the closed eyelids to soften the solidified meibum.
Regrettably, for warm compresses to work well, some scientists state you need to use a compress that can maintain a temperature of 108 degrees Fahrenheit for more than 10 minutes, and the compresses need to be gotten this length of time a minimum of twice a day.
The majority of people are unable or unwilling to perform this kind of dry eye treatment properly, and much shorter and less regular use of variable-temperature warm compresses generally is inadequate.
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.
The patented device fits onto the eye and also over the eyelids and uses precisely controlled heat to the lids to soften solidified meibum. At the exact same time, the LipiFlow system applies pulsed pressure to the eyelids to open and express clogged meibomian glands, thereby restoring the correct balance of oils in the tear movie to alleviate dry eye syndrome.
Lipiflow treatment takes approximately 12 minutes per eye. In a scientific study of the efficiency of the procedure, most patients (76 percent) reported improvement of their dry eye symptoms within two weeks, and patients likewise showed enhancement in the quality and amount of meibomian gland secretions and the period of time their tear film stayed on the eye prior to evaporating. In some cases, nevertheless, it can take a few months for enhancements to end up being evident.
Typically, the useful effects of the LipiFlow procedure last one to three years or longer.
Potential side effects from LipiFlow dry eye treatment include corneal abrasion, eye pain, swollen eyelids, eyelid irritation or inflammation, chalazion, transient blurred vision, itching, and red eyes.
LipiFlow dry eye treatment normally is not covered by medical insurance. Fees for the procedure can differ from one practitioner to another and tend to range from $700 to $900 per eye.
10. Intense Pulsed Light
For well over a decade, the FDA has actually authorized making use of extreme pulsed light (IPL) to treat rosacea on the skin. Rosacea on the skin and eyelid frequently take place together. Ocular rosacea presents with dilated little capillary flowing along the eyelash margin in patients experiencing blepharitis and might contribute to dry eye symptoms.
In IPL treatment, a hand-held device flashes intense light onto the skin. The light is filtered to allow only wavelengths that can be absorbed by the dilated blood vessels. The result of this treatment might be the resolution of the dilated vessels and associated swelling.
Many patients experience relief from their dry eye symptoms and become less dependent on artificial tears and other eye drops to control dry eye symptoms after IPL therapy. For this reason, IPL treatment may be well-suited for dry eye patients who don’t want to be troubled by the hassle of frequent eye drop use.
Patients generally require four to 6 extreme pulsed light treatments, with about one month between each treatment. Typically, the treatments are well-tolerated and are not associated with any down-time. Nevertheless, prior to the treatment it is necessary to talk about with your doctor how much time you invest in the sun.
IPL treatment generally is not covered by medical insurance or vision insurance coverage and it might not be appropriate for patients with particular skin pigmentations.
11. Nutritional Supplements
Doctors sometimes suggest dietary supplements as part of a holistic dry eye treatment plan. Research studies have discovered that supplements consisting of omega-3 fatty acids can decrease dry eye symptoms.
Excellent 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 advise flaxseed oil to ease dry eye.
Drinking more water can help, too. Moderate dehydration frequently makes dry eye issues even worse. This is specifically true during hot, dry and windy weather condition. Merely consuming more water often minimizes the symptoms of dry eye syndrome.
12. Home Remedies for Dry Eyes
If you have moderate dry eye symptoms, there are a number of things you can attempt to get relief before going to the eye doctor:
Blink more regularly. When utilizing a computer system, smartphone or other digital device, we tend to blink our eyes less often than typical, which can cause or worsen dry eye symptoms. Make a conscious effort to be knowledgeable about this, and blink more frequently when using these devices. Likewise, carry out full blinks, gently squeezing your eyelids together to wash your eyes totally with a fresh layer of tears.
Take frequent breaks during computer system use. A great general rule here is to look away from your screen at least every 20 minutes and take a look at something that is at least 20 feet from your eyes for at least 20 seconds. Some eye care practitioners call this the “20-20-20 rule,” and complying with it can assist ease both dry eyes and computer system eye strain.
Eliminate eye makeup completely. Eyeliner and other eye makeup can obstruct the openings of the meibomian glands at the base of the eyelashes, leading to meibomian gland dysfunction and evaporative dry eye. At the end of the day, be thorough about get rid of all traces of makeup from your covers and lashes.
Tidy your eyelids. When washing your face before bedtime, carefully wash your eyelids to remove bacteria that can cause blepharitis and meibomian gland problems that lead to dry eye symptoms. Use a warm, moist washcloth to your closed covers for a minute or more. Then carefully scrub your lids and lashes with a moderate cleanser, such as diluted baby shampoo or premoistened eyelid wipes sold in pharmacies.
Use quality sunglasses. When outdoors throughout the day, constantly use sunglasses that obstruct 100 percent of the sun’s UV rays. It’s best if they feature a wrap-style frame to safeguard your eyes from wind, dust and other irritants that can cause or intensify dry eye symptoms.
Other Dry Eye Treatment Considerations
In addition to the dry eye treatments listed above, your optometrist might suggest several of the following additional steps if any of the conditions below use to you:
Medication modification. Many medications– including antihistamines, antidepressants, contraceptive pill, particular blood pressure medications and more– can cause or get worse dry eye symptoms. Even over the counter (nonprescription) medications for allergies and other conditions can cause dry eyes.
Be sure to discuss all medications you are taking with your eye doctor if you are experiencing dry eye problems. In many cases, changing the type and variety of medications you are taking might help in reducing dry eye symptoms without causing adverse health results.
However, never stop a prescription medication without first going over the matter with your physician. If your eye doctor feels a modification to one of your medications may help ease dry eye symptoms, she or he can discuss it with your physician (or have you discuss it with your doctor) to see if such a modification is possible.
Dealing with eyelid conditions. If you have blepharitis, meibomian gland dysfunction or other eyelid conditions, these often are connected with dry eye disease and need to be attended to as part of your total dry eye treatment regimen. For instance, if you have blepharitis, your eye doctor might recommend use of an antibiotic and/or steroid ointment or eye drop in addition to everyday eyelid cleansing with a non-irritating shampoo.
Terminating or decreasing contact lens wear. If you use contact lenses, it can be difficult to tell if an underlying dry eye condition is triggering contact lens discomfort or if your contact lenses are triggering dry eye symptoms. If you wear contacts, it’s frequently best to discontinue wearing them (or possibly change to day-to-day non reusable contact lenses for part-time wear only) while your dry eye treatment is in progress.