Chronic Dry Eye: A Closer Look

Dry Eye Treatment Options

There are various options available for the management of Chronic Dry Eye. Your eye doctor can provide information about which option is best for your dry eye needs.

Chronic Dry Eye treatment options include

• Over-the-Counter Eye Drops
• Prescription Therapies
• Tear Duct Plugs

Over-the-Counter (OTC) Eye Drops

Eye drops are man-made, lubricant solutions that are used to moisten the eye and thicken tears. They can help

• Lubricate the eyes1,2
• Maintain moisture in the eyes2
• Ease symptoms such as grittiness and dryness1
• Soothe dry eye symptoms associated with refractive surgery (LASIK surgery)3

Understanding Eye Drops

Although there are other medical ways of dealing with dry eyes, non-prescription eye drops continue to be the most widely used treatment.1,4

Eye drops are also helpful to people who suffer from more than dry eye – 14% of dry eye sufferers use eye drops for other eye-related problems (including moistening of hard contact lenses). 4,5

Eye drops come in a variety of formulations designed to manage dry eye needs and different eye conditions. The various types are

• Artificial Tears7: Artificial tears add volume to the tear film as long as they remain in contact with the surface of the eye and are usually recommended for intermittent symptoms.

  These eye drops moisturize and lubricate the eye surface with a mixture of beneficial ingredients that attract and hold water and coat the eye for temporary relief of burning, irritation, and discomfort due to dryness or exposure to wind or sun. They also help protect against further irritation.

• Gels7: Gels for dry eye are thick, non-oily products. They generally contain a higher concentration of lubricating ingredients than artificial tears, and tend to cause blurred vision for the first few minutes until they “melt” on the eye. They are often recommended for nighttime use.

• Ointment8,9: Ointment is usually recommended for intermittent symptoms, including constant dryness and irritation of the eyes. Ointment provides temporary relief for irritated, dry eyes, and helps the eyes stay moist. The lubricating ingredient is similar to petroleum jelly. If you need to use eye drops close to the time that you have put in some ointment, wait at least 10 minutes before or after applying the eye drops.

  Ointment use may cause prolonged blur and is not recommended when clear vision may be required (such as driving or reading). It is often recommended for more severe symptoms or for nighttime use.

• Emulsion/Oil-Based Eye Drops7,10: These may be added if there are problems with the tear-producing glands. These drops replenish a layer of oil in the tear film, reduce tear evaporation, and stay on the eye up to 8 times longer than other types of eye drops.

• Contact Lens Rewetting Drops: There are specially formulated lens-lubricating and rewetting drops specifically designed for contact lens wearers because other types of drops may contain ingredients that can damage the lens.1 Rewetting drops for contact lens wearers are usually not as thick as gels and are designed to provide relief and long-lasting lubrication to help retain moisture.5,11

• Preservative-Free Vials2,7,8: Preservative-free eye drops are available for people who are sensitive to preservatives. Packaging may vary for preserved and nonpreserved eye drops. Generally, preservative-free eye drops come in single-use vials, while eye drops containing preservatives are dispensed in multi-dose bottles.

  Some preservatives commonly used in eye drops may actually worsen dry eye symptoms, particularly when used frequently over a long period (a condition called “medicamentosa”).
  
  There are several types of preservatives on the market. Consult your eye doctor with questions you may have about the use of preservatives and your specific condition.

• Eye Drops for Use After Surgery3: Your eye doctor may recommend the use of eye drops to keep your eyes moist and comfortable after surgery. LASIK surgery is the most common type of refractive surgery or surgery for the correction of vision. Dry eyes are a common risk, caused by the temporary loss of nerves on the eye surface after surgery.

  Your eyes may feel dry for up to 6 months. As always, it is important to speak with your eye doctor about the best type of eye drops for your eyes and your condition postsurgery.

Prescription Therapies

There are additional prescription treatment options available for dry eyes. Consult your eye doctor for more information.

Tear Duct Plugs12,13

Tear duct plugs, also known as punctal plugs or punctal occlusion, are silicone plugs that can be inserted by your eye doctor to close the ducts that drain tears out of the eye. To check if tear duct plugs are right for you, temporary plugs can be inserted, which dissolve with time and will help your eye doctor decide if plugs will reduce your dry eye symptoms before inserting permanent plugs.

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References:
1. FDA Consumer Magazine. Dealing with dry eye. Available at: www.fda.gov/fdac/features/2005/305_eye.html. Accessed November 15, 2005.
2. Medem: Medical Library. Dry eye. Available at: www. medem.com/medlb/article_detaillb.cfm?article_ID=ZZZXQXXV1ED&sub_cat=118. Accessed November 15, 2005.
3. Mayo Clinic. LASIK and other refractive surgeries: say good-bye to eyeglasses. Available at: www.mayoclinic.com/health/lasik-eye-surgery/EY00002. Accessed January 4, 2006.
4. Multi-Sponsor Surveys, Inc. The 2005 Gallup Study of Dry Eye Sufferers: Summary Volume. August 2005:1-160.
5. Mayo Clinic. Hydroxypropyl methylcellulose (ophthalmic). Available at: www.mayoclinic.com/health/drug-information/DR202290. Accessed November 18, 2005.
6. Drug Digest. Artificial tears solution. Available at: www.drugdigest.org/DD/DVH/Uses/0,3915,6355|Artificial%2BTears%2BSolution,00.html. Accessed November 15, 2005.
7. AgingEye Times. Artificial tears: too many choices. Available at: www.agingeye.net/dryeyes/dryeyesdrugtreatment.php. Accessed November 8, 2005.
8. Drug Digest. Artificial tears ointment. Available at: www.drugdigest.org/DD/DVH/Uses/0,3915,7280%7CArtificial+Tears+Ointment,00.html. Accessed on November 15, 2005.
9. MedicineNet.com. Eye care. Available at: www.medicinenet.com/eye_care/page2.htm. Accessed November 18, 2005.
10. Medicine Net. Definition of Meibomian gland. Available at: www.medterms.com/script/main/art.asp?articlekey=7165. Accessed November 17, 2005.
11. Karpecki PM. Selecting an artificial tear for maximum efficacy. Available at: www.refractiveeyecare.com/Oct04%20-%20Karpecki.htm. Accessed January 9, 2006.
12. WebMD. Eye health: dry eyes. Available at: http://www.webmd.com/content/article/81/96835.htm. Accessed January 4, 2006.
13. AgingEye Times. Punctal plugs and moisture chambers. Available at: http://www.agingeye.net/dryeyes/plugsetc.php. Accessed January 4, 2006.