Topical corticosteroids can be used to reduce inflammation, a key component of dry eye syndrome. However, length of treatment should be monitored, due to a potential rise in intraocular pressure and risk of cataracts. For these reasons, corticosteroids should not be used without ophthalmic supervision because of these potential side effects.
Acetylcysteine is a mucolytic product. This acts by breaking down thick, sticky mucus on the surface of the eye enabling tears to flow more easily across the surface of the eye, resulting in a smoother corneal surface. It is used in patients with deficient tear secretion and/or impaired or abnormal mucus production.
This may act as a partial immunomodulator, although its exact mechanism of action is unknown. It is used to relieve dry eyes caused by suppressed tear production secondary to ocular inflammation, as well as meibomian gland dysfunction.
Doxycycline and minocycline have been shown to be effective for treating meibomian gland dysfunction.
Tear secretagogues (muscarinic agonists)
These increase the volume of tears produced by the lacrimal gland and are used for the treatment of Sjögren's disease.
Autologous serum eye drops
Autologous serum eye drops are unpreserved and non-antigenic. They contain growth factors, fibronectin, immunoglobulins and vitamins in a similar or higher concentration to natural tears. They are used for severe dry eye with punctate epithelial defects and corneal damage, to promote re-epithelialization.