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Treatments summary

The most widely used and accepted treatments for dry eye syndrome are summarised below. While we hope that you will find this useful, please note that it is not intended to be a recommend treatment protocol, as each patient's symptoms and circumstances are unique and will often require a combination of therapies.


Dry eye severity
Treatment(s)
Level 1 / Mild

Educational and environmental/dietary modifications


Elimination of offending systemic medications


Artificial tear substitutes, gels and ointments

Level 2 / Moderate (Added if level 1 treatment is inadequate)

Hot Eyelid Compress and Massage


Non-preserved artificial tear substitutes


Topical/systemic omega-3 fatty acids


Moisture chamber spectacles


Anti-inflammatory agents – Topical corticosteroids


Auto-immune treatment – Topical Ciclosporin A


Tetracyclines (for meibomianitis, rosacea)

Level 3 / Severe (Added if level 2 treatment is inadequate)

Autologous serum, umbilical cord serum


Contact lenses


Permanent punctal occlusion


Secretagogues


Punctal plugs (after control of inflammation)

Level 4 / Severe & Disabling
(Added if level 3 treatment is inadequate)

Systemic anti-inflammatory agents


Surgery

  • Lid surgery
  • Tarsorrhaphy
  • Mucus membrane grafting
  • Salivary gland duct transposition
  • Amniotic membrane transplantation

Adapted from Dry Eye Workshop (DEWS) Committee. 2007 report of the DEWS. Ocul Surf. April 2007; 5(2): 65-204