Author: Dr Val Phua MBBS, MMed (Ophth), FRCOphth, FAMS
Photo by: Noah Buscher
Dry eyes are a common cause of eye irritation. It is typically chronic and may be progressive in some cases but with the appropriate treatment given, it can result in significantly less discomfort, less dry eye symptoms and even better vision in some cases. There are different causes of dry eye and various approaches may be used to gain relief. Here are 7 approaches to get relief from dry eyes. Depending on the underlying cause and severity of the condition, a combination of various methods may be used.
1. Artificial Tears
Artificial tears and other lubricating eye drops are a simple and great way of relieving mild symptoms of dry eyes. Patients often come seeking for dry eye treatment after using over the counter lubricating drops. Patients feel they are using it quite often and on further questioning, it can be as much as twice a day. This is often insufficient to adequately relieve the symptoms and the frequency needs to be higher; it is ok to even use it every hour if it really needed.
There are various types of artificial tears and they contain different ingredients and have varying “viscosity”. This refers to how “thick” the eye drops are. Eye drops with low viscosity are “thinner” and more watery, making it easy to apply but it does not last as long in the eye. Eye drops with high viscosity are “thicker” and more sticky. It lasts longer in the eye providing better relief but may cause a slight blurring of vision for a few minutes immediately after application.
The type of dry eye present could also affect which treatment is best for you. Patients who do not produce enough tears (aqueous deficiency) may benefit from a different artificial tears eye drop compared with patients who have tears that evaporate too quickly (evaporative dry eye).
2. Steroid Eye Drops
Inflammation is a significant component in causing dry eyes and it can cause symptoms like redness, eye irritation and a burning sensation. In some cases, artificial tears may not be sufficient to address the dry eye symptoms because the underlying inflammation is not treated. These cases may benefit from the use of steroid eye drops which help suppress this inflammation and relieve symptoms.
Steroid eye drops are often not used in isolation but rather as an additional agent on top of the artificial tears. Long term use of steroids can result in complications like high eye pressure and cataracts but these risk are low when used in short courses to treat dry eyes.
3. Immune Modulatory Therapy
In more severe cases of dry eye, immune modulatory therapy like cyclosporin eye drops are helpful. They not only reduce the inflammation present in the eye, it also helps stabilise the tear film, making the eyes more comfortable and moist. These eye drops take a while to take effect; patients will need to consistently use them for a few weeks to enjoy the full benefit of these eye drops. In the initial stages, application of these eye drops can result in stinging but these tend to improve over time making it more comfortable.
4. Punctal Plugs
Plunctal plugs are small sterile devices that are inserted into the tear duct opening located at the inner portion of the eyelids. Tears that normally drain through the tear ducts are now not able to drain away as fast, allowing them to stay on the ocular surface longer, keeping the eye moist and comfortable. There is the temporary type of punctal plug which dissolves by itself over time and the more “permanent” ones which are able to last for a long time. Punctal plugs are a good complimentary treatment to the use of artificial tears.
5. Nutritional supplements
Supplementing your diet with specific nutrition such as omega 3 fatty acid can improve the quality of the tears produced and hence help dry eyes. There are many brands which carry these dry eye supplements. You could also increase your intake of food rich in omega 3 such as salmon, cod and sardine.
6. Warm compress
Patients with dry eyes often have associated meibomian gland disease. These are oil glands in the eyelid which can get blocked if they are not cleaned properly. It worsens dry eye because the oil is no longer able to coat the tear layer resulting in tears evaporating quickly. One of the ways to clear these clogged glands is the use of warm compress. Simply stated, it is applying heat to soften up and “melt” the hardened meibum, allowing it to drain and clear up.
7. Meibomian gland expression
Inadequate oil being secreted from the clogged oil gland in the eyelid results in dry eyes. One way of clearing this clogged glands is through meibomian gland expression; this involves applying pressure to clear the contents of the meibomian glands. This can cause some short-term discomfort but patients are often satisfied with the result making it an overall worthwhile procedure to consider.