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Treatments and drugs
By Mayo Clinic staff
Effective treatment for dry eyes begins with a careful examination to determine which factors may be causing your symptoms. The goal of treatment is to keep your eyes moist.
- Managing lid problems. If you have an eyelid condition, such as an anatomic abnormality or an incomplete blink that aggravates your dry eyes, your doctor may refer you to an eye surgeon who specializes in plastic surgery of the eyelids (oculoplastic surgeon). If your eyelids are inflamed due to blepharitis, your doctor may recommend regular cleaning of the area with a dilute solution of baby shampoo. Your doctor may also prescribe short-term, nightly treatment with antibiotic drops or ointment or treatment with an oral antibiotic, such as tetracycline or doxycycline.
- Adding tears. You can usually treat a mild case of dry eyes with over-the-counter artificial tears. Your doctor or eye doctor can suggest which drops might be best for you. You can use lubricating drops that don't contain preservatives as often as you need, even several times an hour, to provide relief. If the drops you're using contain preservatives, you can safely use them up to four times a day. Be sure you don't purchase eyedrops with a redness remover, as these may worsen your dry eye symptoms. Using lubricating drops proactively before you begin an activity that tends to aggravate your symptoms may help prevent symptoms. You can also use ointments to ensure lubrication. These ointments can blur vision, so it's best to use them only at bedtime.
- Conserving tears. Your eye doctor may also suggest methods to keep your natural tears around longer. This can be done by partially or completely closing your tear ducts, which normally serve to drain tears away. The tear ducts can be plugged with tiny silicone plugs. The closure conserves both your own tears and artificial tears you may have added. Silicone plugs can be removed or left in. A more permanent option is thermal cautery. In this procedure your doctor numbs the area with an anesthetic and then applies a hot wire that shrinks the tissues of the drainage area and causes scarring, which closes the tear duct.
People with mild dry eyes respond well to treatment with artificial tears. Some people have persistent symptoms and don't respond to artificial tears alone even though their eyes appear fairly normal. Severe dry eyes require more aggressive treatment, such as the silicone plugs. People with severe dry eyes may also benefit from a special customized contact lens (Boston Scleral Lens). This lens rests on the white part of the eye (sclera), creating a fluid-filled layer over the cornea that keeps it from drying out.
Medications
Your doctor may prescribe cyclosporine (Restasis), a medication approved by the Food and Drug Administration (FDA) for chronic dry eyes. Restasis decreases inflammation on the eye surface and helps increase production of healthy tears. Some people experience a burning sensation in their eyes when using this drug. Don't use Restasis if you currently have an eye infection or if you have a history of herpes viral infection of your eye.
When people experience intolerable irritation from dry eyes despite the frequent use of lubricating eyedrops, doctors may prescribe steroid drops to help reduce inflammation.
It's been suggested that a high dietary intake of omega-3 fatty acids or dietary supplements may lower the risk of dry eyes. Additionally, researchers have been investigating the use of topical omega-3 and omega-6 fatty acids to treat dry eyes, and have had some success in animal studies.
