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Dry Eye Syndrome (cont.)

What Medications Treat Dry Eyes?

Certain types of prescription medications may help with DES.

  • Eye lubricants may be prescribed, including eye inserts. Cellulose is contained in the insert and acts to stabilize and thicken the film of tears over the eyes and to prolong the time the tear film works. The artificial tear insert must be properly inserted, otherwise corneal abrasion may occur.
  • Cyclosporine A 0.5% (Restasis) helps decrease any inflammation on the surface of your eye. This inflammation is thought to decrease the ability of your eyes to maintain a healthy tear film. Used twice a day, cyclosporine 0.5% helps you make healthier tears on your own.
  • Corticosteroid drops (Lotemax, Alrex, FML, Vexol), either alone or used in conjunction with Cyclosporine, reduce signs and symptoms of dry eye. Although the FDA has not yet approved this group of drops for the treatment of DES, they are being successfully used by many ophthalmologists. Corticosteroid drops, if used in excess, may have some health side effects, but new formulations with fewer side effects have become available. Like all medications, these should only be used under your doctor's supervision and according to her or his instructions.
  • Nonsteroidal anti-inflammatory drops (Voltaren, Acular, Nevanac, Xibrom) likewise reduce the inflammation associated with DES.
  • Antibiotics are used if you have blepharitis or meibomian gland dysfunction.
    • Antibiotic ophthalmic ointments, such as erythromycin and bacitracin, among others, are used at night for about seven to 10 days to decrease the number of bacteria that break down the lipid layer of your tear film. These ointments also lubricate your eyes overnight.
    • Oral antibiotics, particularly tetracycline and doxycycline, not only help to decrease the number of bacteria but also help to make the oil more fluid so it flows out of the oil glands more easily. This is often used if you have rosacea. There are many people who have rosacea of the eyelids and do not have the typical changes of rosacea on the rest of the face.

When Is Surgery Appropriate for Dry Eye Syndrome?

Different minor surgical procedures may help in the medical treatment of DES.

  • Near the inner corner of each eyelid are small openings, called punctae, that are the beginning of the normal tear drainage system. A procedure known as punctal occlusion can help by decreasing the normal drainage of your tears off the eye and down the tear drainage system, into the back of your nose, and down your throat. This occlusion is usually a very simple office procedure and only takes a few minutes.
    • Different punctal plugs or lacrimal canalicular plugs can be placed at or just inside these openings to block the normal drainage of tears down the tear drainage system. Just like a stopper that you put in the drain of a sink to keep the water from flowing down the drain, these plugs keep the tears that you have from flowing down the tear drainage system. Therefore, your eyes stay more moist and comfortable, even if you have fewer tears. These plugs can usually be removed very easily, if necessary.
    • Sometimes, in severe cases of DES, these openings are permanently closed, usually by cautery (burning) or laser. This accomplishes the same thing as the plugs, but it is very difficult, if not impossible, to reverse.
  • If you have difficulty closing your eyes for any reason, your eye may dry out because of tear evaporation.
    • Lateral tarsorrhaphy is a procedure during which the lateral (outside) one-third of your eyelids are sewn together to decrease the ability of your eye to open widely and to help your eye close more easily.
    • If stroke or nerve damage keeps your eyelids from closing properly, a small gold weight may be implanted into your upper eyelid to help it close.
Medically Reviewed by a Doctor on 8/31/2015

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