First, the bad news: There's no cure for dry eye, an issue that affects millions of Americans each year, according to the National Eye Institute (NEI). The uncomfortable condition—which occurs when the eyes don't make enough tears, or the right kind of tears—causes the people who have it experience a range of symptoms: scratchy, burning eyes; red eyes; sensitivity to light; blurry vision.
Luckily, those symptoms don't have to be too disruptive: There are various treatment options available—ranging from over-the-counter treatments to certain surgeries—for those who struggle with the condition.
Keep in mind: If you suspect you might have dry eye, it's important to bring it up with your eye doctor ASAP, so a treatment plan can be put into place—not only will it boost quality of life, but it will also prevent eye infections and damage to the cornea, or front of the eye, Arti Shah, OD, fellow of the American Academy of Optometry and optometrist at Elander Eye Care in Santa Monica, tells Health.
While there's no one-size-fits-all approach to dry eye treatment—and your specific treatment plan will depend on the severity, cause, and symptoms of your dry eye—here are some of the most common treatment options eye doctors typically recommend.
According to the NEI, artificial tears, gels, gel inserts, and ointments are recommended as the first line of therapy for dry eye. These products, which are available over the counter (meaning you don't need a prescription for them), offer temporary relief for dry eye symptoms and replace naturally produced tears in patients with a specific type of dry eye known as aqueous tear-deficient dry eye.
When it comes to artificial tears, preservative-free solutions are recommended because they contain fewer additives than solutions with preservatives, which can further irritate the eyes. Many times, mild cases of dry eyes can be managed using OTC tears, William T. Reynolds, OD, president of the American Optometric Association, tells Health. Just be sure to follow the usage safety instructions as directed by the packaging or an eye doc, since improperly using or overusing drops can sometimes worsen eye conditions, says Dr. Reynolds.
As you shop for OTC dry eye products, steer clear of drops that promise to clear up red eyes. These drops, which include Visine and Clear Eyes, constrict the blood vessels in your eyes so that your eyes appear whiter Tom Cruse, OD, optometrist with Insight Vision Group in Denver and site residency director for the Illinois College of Optometry, tells Health. But they're not very effective at treating dry eyes, and if the blood vessels are constricted too long—which can happen if you use these products regularly—you can get "rebound redness," when the drops wear off or you stop using them, says Dr. Cruse.
For moderate to severe cases of dry eye, an eye doctor can prescribe drops that, depending on the cause of your dry eye, either increase tear production or decrease inflammation around the surface of the eyes.
These drops are called cyclosporine (Restasis) and lifitegrast (Xiidra). Cyclosporine works by decreasing damage to the cornea, increasing tear production, and reducing dry eye symptoms, according to the NEI. Cyclospoine, NEI adds, may take three to six months of twice-a-day dosages for the medication to work, which is why in some cases of severe dry eye, doctors will recommend the short-term use of corticosteroid eye drops to decrease inflammation. Lifitegrast works by minimizing the inflammatory cycle caused by dry eye and increased tear production, says Dr. Shah. Lifitegrast can work as quickly as two weeks.
Medication aside, for some patients, a specific type of contact lens called a scleral lens can help hydrate dry eyes, says Dr. Shah. Scleral lenses would be prescribed by your eye doctor, as well.
Surgical and medical procedures
Keeping natural tears in the eyes longer can reduce the symptoms of dry eyes; this can be done by blocking the tear ducts through which the tears normally drain, explains Dr. Reynolds. The tear ducts can be blocked with removable tiny silicone or gel-like plugs, known technically as punctal plugs, per the NEI.
The tear duct plugs are typically reversible, and meant as a temporary fix. But in other, more severe cases, a surgery to manufacture a more permanent plug—known as punctal cauterization—may be warranted. According New York University's Langone Health, during punctal cauterization, an ophthalmologist will apply heat to the puncta (tear ducts) in each eye, permanently closing the ducts. The procedure is done using local anesthesia so patients don't feel pain.
Another surgical option for those with dry eye involves surgically fixing a person's eyelids. In some cases, dry eye can occur because the lower eyelids are too loose, causing tears to drain too quickly from the eye. If this is the cause of your dry eye, your eye doctor may recommend surgery to fix your eyelids and help your tears stay on your eyes, the NEI says, but this procedure is not very common.
An in-office procedure called meibomian gland expression may also be used in some cases of dry eye—specifically if a person's dry eye is caused by inadequate oil (meibum) secretion, according to the Not a Dry Eye Foundation. During this procedure, a doctor may apply heat to the eyelid, and then use forceps or sterile cotton swabs to squeeze out hardened meibum to clear the meibomian glands. In some cases, a newer therapy called the LipiFlow Thermal Pulsation System can also streamline meibomian gland expression by using a device to both heat up and massage away oil blockages in about 12 minutes, according to LipiFlow's manufacturer, Johnson & Johnson.
Lifestyle changes or natural treatments
There are a number of natural treatments you can try to help manage dry eye. One option: Specialized goggles that help seal in moisture around your eyes, says Dr. Cruse. People wear these when they sleep and also sometimes during the day. Also: Warm compresses and eyelid massage or eyelid cleaners, which can help decrease inflammation around the surface of the eyes, says Dr. Reynolds.
You may be also able to reduce the severity of your dry eye symptoms by making simple lifestyle changes, including increasing the humidity of the air at your home and work, wearing sunglasses outside, taking nutritional supplements (like omega-3 fatty acid, which may help boost tear production), changing your diet, and drinking enough water to avoid dehydration, says Dr. Reynolds. You should chat with your primary care doctor before taking new vitamins or supplements, recommends the NEI.
Other lifestyle changes include avoiding smoke, wind, and air conditioning, limiting screen time and taking breaks from staring at screens, and getting enough sleep (that's about seven to nine hours a night).
Lastly, if a part of your lifestyle or routine is causing or exacerbating your dry eye, your doctor might recommend you make changes to help protect your eyes, says the NEI. For instance, if a medicine you take for another health condition is causing dry eye, your doctor may suggest switching to a different prescription.
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