Dry Eye Treatment


Pain, blurred vision, and even loss of sight might result in particularly severe cases.

Tears lubricate {the} inside of {the} eyelids to make blinking smooth and comfortable.

Without them, {the} surface of {the} eye can become irritated, which can potentially cause damage to {the} cornea.

Tears are produced in {the} lacrimal gland (1) and lubricate across {the} eye (2) and are then drained through {the} punta, canalicular drain into {the} lacrimal duct (3).

What Are {the} Purposes of Tears?

As you know, {the} symptoms of dry eye are caused by a reduction in your eye’s ability to produce sufficient natural tears. Tears are important because they serve several functions for keeping {the} eye healthy. The following are just a few:

  • Tears moisturize {the} surface of {the} eye. Tears lubricate {the} inside of {the} eyelids to make blinking smooth and comfortable. Without them, {the} surface of {the} eye can become irritated, which can potentially cause damage to {the} cornea.
    • This prevents {the} cornea ({the} transparent front portion of {the} eye that covers {the} iris, pupil, and anterior chamber) from drying. If {the} cornea dries, it can potentially become damaged.
    • Pain, blurred vision, and even loss of sight might result in particularly severe cases.
  • Tears nourish {the} eye by transporting oxygen to {the} eye and removing carbon dioxide. Without tears, a malnourished cornea can lead to damaged vision.
  • Tears clean and protect {the} eye by washing away foreign particles. Tears contain antibacterial and antiviral substances that help defend {the} eye against infection.

How Are Dry Eye Symptoms Treated?

  • If you suspect you have dry eye symptoms, see your doctor. He or she can determine which treatment is appropriate for you. Depending on {the} severity of your condition, tear replacement is {the} most commonly recommended therapy—this involves {the} use of lubricant eye drops. The primary goal of treatment is to keep {the} eye moist and comfortable and to protect {the} eye’s delicate surface.
  • In addition to making changes to your environment, you might want to also use artificial tears to ease your symptoms.
  • You should also try to eliminate {the} factors that exacerbate or contribute to dry eye: Contributing eye abnormalities (such as blepharitis, an inflammation of {the} eyelids) should be treated.
    • Schedule regular breaks from reading, television viewing, and computer use.
  • Try to avoid excessive heat, air conditioning, and low humidity — they can aggravate dry eye symptoms as can being close to air conditioning ducts or heating vents.
  • Lower your computer screen so that you are looking down at it. This might decrease some of {the} discomfort that is often associated with prolonged computer use.
  • Avoid or eliminate those elements that are known to cause or aggravate dry eye symptoms.
  • The use of antihistamines or diuretics should be decreased as much as possible. However, it is important that you talk to your doctor before adjusting {the} dosage of or stopping any medications.

Treatment with artificial tears/lubricants
Preserved Artificial Tears

  • Artificial tears are a common treatment for dry eye symptoms.
  • They provide moisture, surface wetting, and comfort for people who suffer from dry eye symptoms.
  • Preserved artificial tears are typically recommended for those with mild dry eye symptoms.
    • Systane

Preservative-Free Artificial Tears

  • As your symptoms become worse, you might increase {the} use of artificial tears.
  • Preservative-free tears are often recommended for those with moderate or severe dry eye symptoms.
  • People with sensitive eyes might also prefer nonpreserved tears.
    • Celluvisc
    • Refresh

Thicker Artificial Tears and Ointments

  • Thicker artificial tears or ointments might be substituted if you use artificial tears more commonly.
  • An ointment might be preferred for nighttime use
  • Artificial lubricants such as tears and ointment

Drops with Omega-3 - Thera-tears

  • Omega-3s are essential fatty acids. “Essential” means that, because they cannot be produced by {the} body, their inclusion in {the} diet is essential for good health. The two best sources of omega-3s are dark, oily, cold-water fish, and flaxseed. They are known to have a multitude of health benefits, yet, as a population, Americans are omega-3 deficient—it has been estimated that 83% of Americans are deficient in omega-3s.1,2 North Americans have among {the} lowest dietary intake of omega-3s in {the} world (Figure 1).

    Figure 1. North America has among {the}
    lowest omega-3 consumption in {the} world

    Omega-6s are another group of essential fatty acids. Americans obtain an excess of these through their consumption of beef, dairy, vegetable cooking oils, and vegetable shortenings (i.e. cookies, potato chips, snacks etc.). Unfortunately, while {the} recommended ratio of omega-3s to omega-6s is 1:2.3, {the} existing ratio of omega-3s to omega-6s consumption has been estimated to be as low as 1:10.

    Omega-3s and Dry Eye
    Omega-3s decrease inflammation

  • Omega-3s in {the} diet, once consumed, are elongated by enzymes to produce anti-inflammatory prostaglandin E3 (PGE3) and anti-inflammatory leukotriene B5 (LTB5)
  • Even more importantly, eicosapentaenoic acid (EPA), a long-chain omega-3 provided directly by fish oils, blocks {the} gene expression of {the} pro-inflammatory cytokines tumor necrosis factor alpha (TNF-a), interleukin-1 alpha (IL-1a), interleukin-1beta (IL-1b), proteoglycan degrading enzymes (aggrecanases) and cyclooxygenase (COX-2)
  • There is an abundance of clinical evidence that ingestion of omega-3s decreases {the} inflammation seen in {the} joints in rheumatoid arthritis 3-6 and in {the} skin in dermatitis as well. 7These anti-inflammatory effects go a long way to explain why omega-3s have been useful in helping patients with symptoms of posterior blepharitis or meibomitis. 8 In my practice, omega-3s have been displacing my use of systemic tetracyclines as treatment for {the} eye irritation that my meibomitis patients experience upon awakening in {the} morning. But {the} effects of omega-3s only begin with their effects on meibomitis.
  • The effects of suppressing pro-inflammatory cytokines don't stop here. We now know that {the} pro-inflammatory cytokines TNF- a , IL-1 a , and IL-1 b , impair tear secretion in lacrimal gland disease-based dry eye by inhibiting {the} release of neurotransmitters from neural synapses, and interfering with {the} secretory response of lacrimal gland acinar cells to stimulation. This is probably {the} main mechanism by which tear secretion decreases in dry eye.
  • Meibomian glands use essential fatty acids to synthesize oil (meibum). Dietary intake of omega-3s in general, and EPA and DHA in particular, have recently been shown to affect {the} polar lipid profiles of meibum as observed by HPLC. 25 Indeed, Boerner has observed {the} clearing and thinning of meibomian gland secretions with omega-3 supplementation. 8 Further studies are needed to determine whether these effects are sufficient to bolster {the} oil layer and retard evaporation.

Stimulation of tear production

  1. Oral pilocarpine
  2. Restasis
    • Restasis ® Ophthalmic Emulsion is {the} only prescription eye drop indicated to increase tear production which might be reduced by inflammation on {the} eye surface in patients with Chronic Dry Eye.
    • Increased tear production was not seen in patients using topical steroid drops or tear duct plugs. The approved treatment is one drop in {the} morning and one drop at night in each eye, every day
    • Unlike artificial tears, Restasis® Ophthalmic Emulsion helps increase your natural ability to produce tears which might be suppressed by inflammation due to Chronic Dry Eye.
    • Indeed, numerous patients using Restasis® report a noticeable increase in tear production with continued use.
    • What to Expect
      • Restasis® Ophthalmic Emulsion works gradually to increase tear production. Individual results might vary.

      Initial Results

      • You might originally notice you're using artificial tears less and less. Over {the} course of time, you might be able to discontinue their use altogether.

      After Three Months

      • By {the} end of {the} third month numerous users can experience a significant difference in tear production.

      Continue Using Restasis®

      • As shown in six-month clinical studies, {the} benefits of Restasis® Ophthalmic Emulsion depend upon continuous use of {the} product.

Maintenance of Moisture

Moisture Chambers


Punctal Occlusion



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