See Your Doctor
Even though many treatments for dry eyes are available without a prescription, it's wise to see a health care professional to evaluate the cause of the condition and to help you pick the best treatment.
Diagnosis of Dry Eyes
Eye doctors use a combination of routine clinical exams and other specific tests for dry eyes. For example, the Schirmer test uses a tiny strip of paper placed on the edge of the lower eyelids. This measures how much moisture is in the eye, and it's also useful for determining the severity of the problem. Doctors may also use dye, such as fluorescein or rose bengal, which is placed on the eye to stain the surface. This is to see how much the surface of the eye has been affected by dryness. Another test, tear break-up time (TBUT), measures the time it takes for tears to break up in the eye.
What Are Artificial Tears?
The first line of treatment for dry eyes is usually over-the-counter demulcent drops, also known as artificial tears. These lubricate the eye and ease symptoms. Commonly found ingredients in these products include hydroxypropyl methylcellulose, the ingredient in Bion Tears and GenTeal, and carboxymethylcellulose, contained in Refresh Plus and Thera Tears. Always read the directions, but these products can generally be used as often as needed throughout the day.
Your health care professional can guide you in choosing the right one for you. Some people use drops for red eyes, but that can make the eyes even more dry. Red eyes could be caused by numerous factors, from allergies to an eye infection, which is why a proper diagnosis is important. If you wear contact lenses, use rewetting drops specifically for contact lenses. Other types of drops may contain ingredients that damage the lens.
What Is Restasis?
Restasis (cyclosporine ophthalmic emulsion) is the only prescription product for chronic dry eyes. Approved by the Food and Drug Administration in 2002, the drug increases tear production, which may be reduced because of inflammation on the eye surface. In a clinical trial involving 1,200 people, Restasis increased tear production in 15 percent of patients, compared with 5 percent of patients in the placebo group.
Restasis is usually given twice a day, 12 hours apart. It should not be used by people with eye infections or hypersensitivity to the ingredients. It has not been tested in people with herpes viral infections of the eye. The most common side effect is a burning sensation. Other side effects may include:
- eye redness
- discharge
- watery eyes
- eye pain
- foreign body sensation
- itching
- stinging
- blurred vision
For More Information On Drugs Used To Treat Dryness
What Are Punctal Plugs?
For people who have not found dry eye relief with drugs, punctal plugs may help. These are reserved for people with moderate or severe dry eye when other medical treatment hasn't been adequate.
In each eye, there are four puncta, little openings that drain tears into the tear ducts. Punctal plugs are inserted into the puncta to block tear drainage. Some doctors try out temporary ones made of collagen first to make sure that permanent ones will not cause excessive tearing. Permanent plugs are usually made of silicone. In recent years, some plugs have been approved that are made of thermally reactive material. Some of these are inserted into the punctum as a liquid and then they harden and conform to the individual's drainage system. Others start out rigid and become soft and flexible, adapting to the individual's punctal size after they are inserted. Artificial tears are usually still required after punctal plug insertion.
Experts stress, the risks of punctal plugs are fairly minimal, but there is a risk of eye irritation, excessive tearing, and, in rare cases, infection.
Related Resources - Dry Eyes
Source: Dealing with Dry Eye, by Michelle Meadows, FDA Office of Public Affairs, FDA Consumer Magazine, May-June 2005 Issue
