Dry Eyes Treatments

What Is Dry Eye Syndrome?

Woman using dry eye drops

Your eyes need to stay moist and lubricated. Contrary to popular belief, the tears your body makes to coat and soothe your eyes are not just slightly salty water, but a complex combination of oil, water, and mucus…with a few other chemicals as well.

When the tear-producing glands, called the lacrimal glands, either do not produce enough tears, are blocked, or produce tears with the wrong chemical balance, you get dry eye syndrome. Other names for Dry Eye Syndrome are Dry Eye Disease and Dry Eyes. Whatever you call it, your lacrimal glands may end up working overtime to fix the problem…which may result in tears running down your cheeks.

Dry Eye Symptoms

You may experience excessive tears in the early morning such that you have a hard time seeing because of all the moisture. On the other extreme, you might also feel that your eyes just feel dry, almost like there are threads or eyelashes in your eyes. Your eyes may turn red, sting, burn and feel a bit scratchy.

Dry, irritated eyes as well as wet and teary eyes can also cause intermittent blurry vision.

One very common symptom is that your eyes become a source of frustration and distraction, causing you to need to close your eyes for a bit, and even find somewhere to go where the light is less bright.

Do You Need To Treat Dry Eyes?

Blocked meibomian glands as indicated by the white dots

Many patients ask whether they need to treat dry eyes, especially if their symptoms seem to go away during parts of the day. Because the results of dry eyes can be much more severe than mere discomfort, the answer is yes.

Your tears are there to help lubricate and protect your eyes. If there is a shortage of tears (or the right kind of tears):

• The surface of your eyes may become scratched or irritated.
• Your eyes may become inflamed
• You may develop an eye infection
• You may develop corneal ulcers
• You may lose some or all of your vision

The glands in your eyes that make the oils are called meibomian glands — probably a body part you never knew you had. Dry eyes can cause the meibomian glands to slowly atrophy, causing them to lose their ability to make the oils long term.

That’s why your dry eyes should be treated as soon as possible.

Over the Counter Dry Eye Treatments

There are many very good over the counter dry eye treatments that you can experiment with, most in the form of eye drops. One major difference between the different types of drops is the viscosity (thickness) of the drops. Some people prefer more watery drops and others prefer the thicker drops, especially at night.

It’s important to know that these over-the-counter drops, which are often called “artificial tears,” help to moisten the eyes and provide temporary relief of your dry eye symptoms. But they do not increase your eyes’ ability to make their own tears, which is something that prescription dry eye drops can do.

Among the more popular brands of over the counter treatments for dry eyes are:

• Oasis Tears Plus — These eye drops are quite thick. When taking them, your vision might be blurry for a few minutes, which is why so many people use them before bed. It’s important to stay inactive until the blurriness goes away. These tears are so effective and soothing, however, that we often recommend that scleral lens wearers (see below)put a few drops of Oasis Tears Plus into their contact lens saline solution.
• Systane Complete PF — These drops, which boast “nano-droplet technology”,  promise 8 hours of long-lasting relief from all major types of dry eye disease. The PF stands for Preservative-Free.
• Refresh Relieva PF — This preservative-free eye drop is an extremely popular dry eye treatment which can help to relieve discomfort from dry eyes and prevent further irritation.

Whichever eye drops you choose, make sure that they are specially formulated for Dry Eyes and that they are preservative free (PF). Why? Because ironically, some preservatives can cause dryness.

Warm Compress

Another over-the-counter dry eye treatment isn’t a medicine at all. It’s a warm compress placed over your eyes. To make a warm compress, moisten a clean washcloth and heat it in the microwave for 10 to 20 seconds or longer, making sure it is not hot enough to hurt or harm you. Lay back and place it across your eyes for 5 minutes or more. The compress sometimes has the effect of unclogging your meibomian glands, which excrete the oils onto your eyes. A compress can provide temporary relief of some dry eye symptoms.

Prescription Dry Eye Treatments — Drops

An ironic symptom of dry eyes is that your eyes make excessive tears.

Prescription dry eye treatments can be very expensive, and not all medical insurance companies have all of these prescription drops on their formularies. As a result, you may find that some drops are not covered at all, some are covered minimally, and in some other cases, your insurance company may recommend a different drop on this list (or not on this list).

Whatever you use, be sure to follow your doctor’s recommendations for dosage and frequency.

• Xiidra — These drops come in single dose plastic vials. Twist off the top, put one drop in each eye, and then dispose of whatever may remain in the vial (there is usually another drop or two, in case one of your doses ends up on your cheek or eyelid.) Xiidra is a strong medicine and so your eyes may sting due to your eye’s current dryness, much like an antiseptic stings when you treat a scratch on your skin. Xiidra begins to take effect after 4 to 6 weeks.
• Restasis — Restasis is among the most popular dry eyes treatments and is designed to increase tear production for people with ocular inflammation. The main ingredient is cyclosporine. While Restasis is very effective, it can take longer to create a significant difference, which is why it is often recommended to use over the counter eye drops (those listed above) until the Restasis reaches its full effect. (There is also a relatively new generic version of Restasis which may be approved by your insurance company if the brand name medicine is rejected.)
• Cequa — Cyclosporine is also an active ingredient in Cequa, the new Dry-Eye kid on the block. Cequa has 0.09% cyclosporine (as compared to Restasis with 0.05% cyclosporine) and also features new NCELL nano-technology allowing it to penetrate the aqueous layer of the tear film to better deliver the cyclosporine.

Whichever medicine you use, your eye doctor may recommend that you hold your “puncta” (the drains in your eye) by pinching near the bridge of your nose for 30 seconds or longer. This helps to keep the medicine on the surface of your eye longer.

Surgical Dry Eye Treatments

Your dry eyes might be caused (or made worse) by your puncta allowing your natural tears to drain too fast. To address that issue, they can be partially closed using small “punctal plugs”. They are made of natural materials and often dissolve within 30 to 90 days. Some are designed not to dissolve at all. With either type of plug, it’s a procedure that can be done in your Optometrists office during a regular visit.

Contact Lenses to Treat Dry Eyes

While soft contact lenses are frequently prescribed for many common eye issues, such as nearsightedness and farsightedness, scleral lenses are prescribed for more complex diseases like Keratoconus and other corneal dystrophies. Scleral lenses are hard lenses that are designed to cover 100% of the cornea and most of the sclera — the white parts of the eye.

And while traditional hard and soft contact lenses are designed to rest directly on the eye, Scleral lenses rest on the sclera and vault over the cornea entirely. The space between the back of the lens and the surface of the eye is filled with a saline solution — and often a few drops of an over the counter dry eye treatment like Oasis Tears Plus. This causes the surface of your eye to always be covered by a layer of fluid that helps to keep your eyes healthy.

Your eye doctor may prescribe scleral lenses for you to wear during the day along with prescription eye drops for dry eyes in the morning and evening.

Scleral lenses are an effective treatment for dry eye disease.

Other Prescription Dry Eye Treatments

There are still other treatments for dry eyes. One of them is called Lacrisert which is inserted behind your lower eyelid and which lubricates your eyes for about 24 hours.

Another treatment is Serum Tears, which are made from your own plasma. A representative from the manufacturer comes to your home to take some blood. The plasma in your blood is used to make artificial tears that include your own body’s nutrients. You apply these Serum Tears two to four times a day, or to fill your scleral lens bowl before applying it to your eye.

The Best Treatment For Dry Eyes

So which is the best treatment for dry eyes? The answer depends on several factors, including the type and severity of your dry eyes. Mostly, however, the best dry eyes treatment for you is the one that you will follow. If you suspect you have dry eyes, or if you have already been diagnosed with dry eye syndrome, make an appointment with the dry eyes experts at Dr. Barry Leonard and Associates. Call our office at 818-891-6711 or make an appointment online.