Medications

Certain prescription medications may help with DES.

• Eye lubricants may be prescribed, such as Lacrisert, an artificial tear insert. The insert is similar to a contact lens and is inserted one to two times per day. 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 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.