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Dry Eye Syndrome (cont.)

What Medications and Procedures Treat Dry Eyes?

When over-the-counter eye lubricants are insufficient, prescriptions medications may be necessary.

  • Cyclosporine A 0.5% (Restasis) and lifitegrast 5% (Xiidra) drops decrease inflammation in certain patients, particularly those with autoimmune disorders. Corticosteroid drops (such as fluorometholone, loteprednol, or prednisolone) also decrease inflammation. Corticosteroid drops, while very effective in most cases, should only be used under your doctor's supervision and according to her or his instructions because they carry risks for serious side effects such as keratoconjunctivitis infection, glaucoma, and cataracts.
  • In advanced cases of dry eye syndrome, specially compounded treatments such as autologous serum drops, topical vitamin A ointment, and certain hormonal compounds may also help.
  • Antibiotics drops or ointment are used if you have blepharitis.
  • Low dose oral antibiotics doxycycline and minocycline are often helpful in controlling meibomian gland dysfunction, particularly when associated with rosacea. Vitamin A supplements and correction of other nutritional deficiencies may be necessary. This is particularly the case in those with malabsorption following gastric/intestinal surgery.
  • Punctal occlusion: Near the inner corner of each eyelid is a small opening called a punctum that is the opening into the nasolacrimal duct, which is the drainage system connecting the tears to the inside of your nose. A procedure known as punctal occlusion can help dry eye syndrome by decreasing the drainage of tears into this tear drainage system. Tiny punctal plugs can be placed at or just inside these openings to block the normal drainage of tears, just like a stopper that you put in the drain of a sink to keep the water from flowing down the drain. These plugs can be temporary, made of a dissolvable material, or permanent. They can be removed if they result in excess tearing.
  • In severe cases of dry eye syndrome, the punctum can be permanently closed by cautery (heat) or laser.
  • Lateral tarsorrhaphy is a procedure in which the lateral (outside) one-third of your eyelids are taped, glued, or sewn together to decrease the amount of the eye that is exposed. This is typically reserved for extreme cases. If stroke, scarring, or nerve damage keeps your eyelids from closing properly, the eyes may need to be taped closed at night. Special goggles can also be worn to serve as moisture chambers. In some cases, small gold weights may be implanted into your upper eyelid to help it close all the way.
  • Following a severe chemical injury or burn to the ocular surface, special bandage contact lenses such as those made from amniotic membranes may speed healing.
Medically Reviewed by a Doctor on 9/11/2017

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Dry eye is a multifactorial disease of the tears and the ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface.

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