Lifestyle and environment factors
Following a diagnosis of dry eye syndrome, your doctor or optometrist will initially focus on identifying and addressing lifestyle/environmental factors that may cause or worsen dry your symptoms. These include:
- Smoky or dusty environments
- Air conditioning/heaters in the home and car
- Prolonged viewing of computer screens
- Contact lens wear
- Over-rinsing with water or saline
- Use of redness-relieving eyedrops such as witch hazel
A good level of daily water intake will also be encouraged to aid hydration. As omega-3 fatty acids may reduce tear evaporation and inflammation, oral supplements or dietary intake via fish or flaxseed oil is also often recommended.
Artificial tears and lubricants
The term 'artificial tears' is commonly used to describe drops, solutions and liquid gels applied directly into the eye. The term is not strictly correct, however, as artificial tears don't have all the components of real tears - they mainly just act as a lubricant. The term 'ocular lubricants' generally refers to more viscous products such as ointments. Your doctor or optometrist may recommend or prescribe artificial tears or an ocular lubricant in addition to addressing the above lifestyle and environmental factors.
Hydroxypropyl methylcellulose inserts (lacriserts) are small pellets that contain artificial tears. They are inserted under the eyelid once-daily, to help keep the surface of the eye moist. As a sustained-release formulation for artificial tears, the effect can last anywhere from 6 to 12 hours. Lacriserts are sometimes recommended when dry eye symptoms cannot be controlled by frequent use of normal artificial tears.
Some cases of dry eye syndrome can be treated using specially made glasses, known as moisture chamber spectacles. These wrap around the eyes like goggles, helping to retain moisture and protecting the eyes from irritants. Their popularity is increasing as modern designs look like sports sunglasses, unlike the more cumbersome appearance of earlier versions.
Specialist contact lenses
If regular contact lenses are causing dry eye syndrome, specially designed ones are available to help overcome the problem. Your optometrist or ophthalmologist will be able to give you more information on contact lens options.
Anti-inflammatory medicines can be used to help reduce the inflammation associated with more severe cases of dry eye syndrome. They are normally prescribed in the form of a cream or ointment. Specialist oral medications are sometimes used if products and medicines applied directly into the eyes prove unsuccessful. These oral treatments include tetracycline analogues, ciclosporin and tear secretagogues. Your doctor will provide more information on these if they are needed.
The majority of dry eye treatments do not include surgery but if they do they might include:
- Punctal occlusion
Small plugs are used to seal the tear ducts, helping tears to pool and thus protect the eyes. Temporary plugs made of silicone are normally used first to see if the operation has a positive effect. If so, the tear ducts can be permanently seared shut, using a laser or electric heating device.
- Salivary gland autotransplantation
In this procedure, some of the glands that produce saliva are removed from the lower lip and grafted into the side of the eyes. The saliva produced acts as a tear-substitute.