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HealthInfo Canterbury

How are dry eyes treated?

There are several things you can do to help keep your eyes moist.

Change your environment

wraparound sunniesThings in the environment might be making your tears evaporate too quickly.

When you are inside, use a humidifier to put more moisture into the air. Reduce air movement and temperature by slowing down any fans, air conditioning or heating.

Outside, wear well-fitted wrap-around sunglasses to protect your eyes from the wind.

Change how your eyes work in the environment

If you are doing concentrated eye work, such as reading, watching TV or working on a computer, make sure you take breaks. Closing your eyes for 10 seconds every five to 10 minutes will help, as will blinking more often.

If you sleep with your eyes slightly open, or your pillow pushes your eyelids open, tape your eyelids shut with a gentle medical tape at night.

Compresses, cleansers, drops, and gels

Use hot compresses, eyelid massage and scrubs with baby shampoo (or other lid cleansing products) to help provide a thicker, more stable layer of oil. The Eyelid inflammation page has instructions on how to clean your lids.

This is especially helpful if your meibomian glands aren't working properly, or you have rosacea or blepharitis. The heat warms the oil in your glands so it flows more easily and the massaging helps get it out of the glands. The cleansing decreases the number of germs (bacteria) that break down the oil.

Buy artificial tear or lubricating eye drops or ointments from a pharmacy or optometrist and use them regularly (four times a day or more). If you use these more than six times a day, it's best to get preservative-free solutions. You may need to try several different products to see which one works best. Eye ointments are thicker and last longer but they can blur your vision, so it's best to use them just before going to bed at night. You may be able to get some of these artificial tears or lubricants on prescription.

Try not to use decongestant eye drops, as these dry your eyes.

Increase your omega-3 intake

Take a fish oil, flaxseed oil, or other omega-3 fatty acid supplement every day.

Treatments your optometrist or doctor may prescribe

If the treatments you can do yourself don't work, your optometrist or ophthalmologist (eye doctor) might suggest one of the following treatments, depending on what is causing your dry eyes.

Medications

Cyclosporine A 0.5% eye drops help to decrease any inflammation on the surface of your eye, making it easier to keep a healthy film of tears over them. Non-steroidal or steroid drops can also reduce inflammation. If you use steroidal eye drops, your optometrist or ophthalmologist will need to closely monitor you to make sure you don't have any harmful side effects, such as cataracts or eye infections.

Oral antibiotics, like doxycycline, can help to decrease the number of bacteria that break down the oil in your eyes, and also help the oil flow out of your glands more easily.

Minor surgery and other procedures

Temporary punctal cautery is a minor, reversible procedure to block some of the channels that drain tears from your eyes. These channels are called puncta.

In this procedure an ophthalmologist easily and painlessly puts a plug in one of the channels, to stop your tears from draining. If the plug needs to be removed, they can easily do this during another consultation.

In severe cases the tear drainage openings can be permanently closed, usually by cautery (burning) or laser.

Surgery can correct abnormalities of your eyelids such as ectropion or Bell palsy. For example, in lateral tarsorrhaphy the outside one-third of your eyelids are sewn together to help your eyes close more easily. This can either be temporary or permanent, depending on whether the problem being treated is temporary or permanent.

If you have severe dry eyes, serum eye drops can be made from your own blood. These are available through a private ophthalmologist, and in some cases may be publicly funded.

Written by Canterbury optometrists. Adapted by HealthInfo clinical advisers. Endorsed by clinical director, Ophthalmology, Canterbury DHB. June 2016.

Sources

Page reference: 206996

Review key: HIDRE-206293