Dry Eye Treatment - Our Doctor's Dry Eye Treatment Checklist
Updated: Sep 15, 2020
One of the most common complaints we get at our office is the feeling of dry, burning, or irritated eyes. The truth is, these are symptoms of dry eye, a disease that is extremely common. Fortunately, this annoying disease can be effectively managed over time.
In this article, I’ll go over our complete dry eye treatment checklist, including environmental, nutritional, over the counter, and prescription dry eye treatment options.
Environmental changes for dry eye
Surprising to many, modifications to your environment can greatly reduce undesirable dry eye symptoms. Plus, they’re often free and something you can control. Here are a few to consider.
First, eliminate running the ceiling fan at night and angle air from vents in your car, home, and work away from your face. If you must sleep with a ceiling fan on at night, wear a sleep mask and use liquidgel to protect the surface of your eyes.
Speaking of rest, make sure to get 7-8 hours of good sleep a night. Keep in mind that adding a humidifier to your bedroom can significantly help improve your air and sleep quality (especially in the winter months).
Next, smoke of any kind is not your friend. Therefore, avoid being around cigarettes, cigars, or fireplace smoke.
Lastly, stay hydrated and remember to take breaks from digital devices. I know, I know, this is easier said than done! Just remember to take a break and blink every 20 minutes for 20 seconds (or take a 5-minute break every hour).
Nutrients for dry eye
Not only does nutrition have a pivotal role in your general health, but it also plays a key role in your eye health. One of the things that can be improved with proper nutrition is dry eye! With this in mind, let’s dive into some vitamins you need to increase to improve your dry eye.
First, increase your vitamin A intake. This can be done by consuming eggs and skim milk as well as red, orange, yellow, and dark green leafy vegetables.
Next, increase your zinc and folate intake. This is best done by eating nuts, dairy, whole grains, beans, oranges, bananas, and raw vegetables.
Lastly, ensure you’re getting sufficient vitamin B6 and potassium intake. Eating poultry, nuts, bananas, potatoes, vegetables, and beans can really help with this.
Our doctors preferred dry eye vitamin is EyePromise EZ Tears. The supplement is designed to help people with occasional dry eyes produce more natural tears with a greater level of lubrication to relieve associated eye discomfort and irritation. Furthermore, EyePromise EZ Tears boast the following features:
A high percentage of DHA and EPA (specifically DHA 440 mg and EPA 590 mg).
A formula that works from the inside out.
Extended hours of comfortable contact lens wear.
An unconditional 30-day, money-back guarantee.
Eye drops for dry eye
Through a simple trip to the convenience store, you'll discover there are several over the counter and prescription eye drops for dry eye. Below are some of the best eye drops we prescribed for our patients.
Over the counter artificial tears
For mild dry eye, we recommend our patients try Refresh Optive Advanced, Systane Ultra, Systane Balance, Blink Tears, or Thera Tears.
For moderate to severe dry eye, thicker tears can help. For these patients, we recommend Blink Gel, Genteal Gel, or Refresh Liquigel (at bedtime only).
Furthermore, if you're sensitive to preservatives, most of these drops are available in preservative-free formulations.
Prescription eye drops
Restasis, Xiidra, and Cequa are all prescription eye drops designed to increase tear production.
The first eye drop to the market in this category was Restasis. This drop is dosed twice daily in both eyes and can take up to six months to activate.
Next to the market was Xiidra. This drop is dosed twice daily in both eyes and takes as little as two weeks to activate.
The newest player in the market is Cequa. This drop is dosed twice daily in both eyes and takes up to 3 months to activate.
On the other hand, steroid eye drops decrease inflammation. Soft steroids such as Alrex or Lotemax can be used short term and are dosed one drop twice daily for up to two weeks.
The Eye Doctor Plus Premium Eye Compress is used to heat your eyelids externally, allowing the oil within your eyelid (meibomian) glands to freely release onto the front surface of the eye. We recommend heating the mask up for 20-30 seconds in the microwave and placing it over your eyelids for 5-10 minutes (note: you can also heat it up in the oven). This can be done 2-3 times a day and can also help with a hordeolum or chalazion. Features include:
It's reusable and has a hygienic removable washable cover.
An adjustable comfort strap.
A pouch for safe, clean, dry storage.
Meibomian gland expression
As referenced above, the meibomian glands within your eyelids can harden and become physically blocked. This prevents the oil from naturally releasing on the front surface of the eye to stabilize the tear film. As a result, multiple devices have come to the market to heat and pressure the glands to alleviate blockages (as well as to remove residue along the lid margins). It's also important to note that these devices need to be used before the glands become completely inactive.
While we don't have one of these devices yet, we plan on purchasing one soon (and can refer you to an office that does if your need is urgent)!
Unfortunately, dry eye and blepharitis routinely go hand in hand. To effectively manage blepharitis, our doctors recommend Ocusoft Lid Scrub Foaming Eyelid Cleanser and Heyedrate Lid and Lash Cleanser.
Both products effectively remove oil, pollen, debris, and other contaminants from the eyelids to provide relief of symptoms associated with blepharitis and other eyelid conditions.
How to use Ocusoft Lid Scrub Foaming Eyelid Cleanser
Make sure hands are clean and pump the desired amount of foam onto a clean, lint-free washcloth or fingertips.
Close eyes and gently massage onto eyelids using a side to side motions for approximately 30 seconds.
Rinse thoroughly with water and dry with a clean towel.
Repeat morning and evening for best results.
How to use Heyedrate Lid and Lash Cleanser
Clean the eyelids of any debris or makeup.
Spray closed eyelids with the solution.
Gently rub into the upper and lower lid and lash margin (or just let it dry...no need to rinse!).
Repeat morning and evening for best results.
In some patients with dry eye, tears drain off the surface of their eyes too fast. To combat this, we can block the drainage pathway of the eye using punctal plugs. They're available as temporary or permanent options and are placed in the tear ducts to keep tears on your eyes longer.
Reserved for moderate to severe dry eye disease, amniotic membranes are used to decrease inflammation/scarring and to promote the healing of damaged eye surfaces. Amniotic membranes act as a therapeutic bandage that keeps the eye moist and protects the ocular surface. This helps controls eye inflammation and promotes the regeneration of corneal nerves.
Scleral lenses are large-diameter lenses that completely vault the front surface of the eye (i.e. the cornea). In doing so, they hold a constant layer of moisture that provides relief and healing of the eye. This is particularly the case for people suffering from incomplete blinking or advanced dry eye disease.
Autologous serum drops
For advanced dry eye that hasn't responded to other treatments, we can always try autologous serum drops. These eye drops are compounded at special pharmacies using your blood serum and have proved to be effective for severe cases.
Let us help you with your dry eyes!
In the end, dry eye is an annoyingly complex condition that we see all the time. As a result, we know that not everyone experiences the same level of discomfort and that not all treatment options provide the same level of relief. To get a thorough assessment of your dry eye disease, schedule an appointment with our eye doctors today!