DRY EYE SYMPTOMS

TREATMENT OF
DRY EYE
SYMPTOMS

TREATMENT OF DRY EYE SYMPTOMS

Artifical lubricants/tears are the mainstay of therapy for dry eyes. In the more severe cases of dry eye, sustained release tear inserts can be used. Artificial collagen inserts and/or permanent punctal plugs can also be inserted to help preserve the tears that are produced. Steroids and/or cyclosporine may be used to treat patients with dry eyes caused by autoimmune diseases such as keratoconjunctivitis sica, rheumatoid arthritis, etc.

Diagnosis and Treatment of Tear Deficiencies
Source: Duane's Clinical Ophthalmology
Volume 4 Chapter 14 Diagnosis and Treatment of Tear Deficiencies - Copyright 1991

Tear Replacement with Artificial Tears/Lubricants

There are a wide variety of artificial tears available and it may be necessary for a patient to try several different formulations in order to find one that provides the greatest amount of comfort and relief.

Artificial tears can be divided into three groups:

  • With preservatives;

  • Preservative-free; or

  • Preservative free on contact

Preservatives help to retard bacterial growth. If the bottle of artificial tears comes in contact with the surface of eye while instilling the drops, bacteria from the eye can contaminate the remainder of the drops in the bottle. Preservatives prevent this contamination from taking place. Preservatives found in artificial tears can cause itching due to an allergic reaction, or can become toxic to the ocular surface, leading to irritation and inflammation. Some patients who require artificial tears more than four times a day may be required to use preservative-free artificial tear formulations.

The various artificial lubricants available for dry eye treatment also have a range of viscosity. In patients with more severe dry eye symptoms an artificial tear ointment or gel at bedtime helps to provide lubrication throughout the night. These ointments tend to blur vision and therefore have limited usefulness throughout the day.

Steroids

Corticosteroids are used routinely after LASIK to reduce post operative inflammation and to relieve dry eye symptoms which are similar to those experienced by people with auto immune disease.

Tear Preservation with Temporary Collagen Inserts or
Permanent Punctal Plugs

Patients that do not find sufficient relief from artificial tears and have displayed evidence of decreased tear production, may be treated by the insetion of punctal inserts or plugs.

Both superior and inferior puncta are important in tear drainage. Rods or plugs can be inserted to block the puncta thus stopping the tears that are naturally produced from draining away.

Collagen Punctal InsertDissolvable punctal collagen inserts can be used as a cost-effective way to evaluate the benefits of permanent punctal occlusion. The collagen inserts are effective for 3-5 days and dissolve in approximately 7-10 days.

Permanent Punctal PlugPermanent Punctal plugs do not dissolve. They can be surgically removed if the need arises.

 

 

Tear Stimulants

The use of substances to increase lacrimal gland secretion is another option in the treatment of moderate to severe dry eye. They have been used both topically and systemically. Two such products are Bromhexine chloride and Eloisin. In order for tear stimulants to work, there must be adequate functional lacrimal tissue present.

Tear Replacement with Sustained Release Tear Inserts

Sustained release tear inserts reduce the necessity for frequent instillation of artificial tears. These inserts can be very useful in treating patients with moderate to severe dry eye syndrome, however, they tend to blur vision several hours after insertion. They are difficult for some patients to handle and are significantly more expensive than artificial tears. Tear inserts would be contraindicated in the first few weeks post LASIK because of the potential to cause wrinkles in the flap.

Hormones

Hormone deficiencies (i.e. estrogen) have a strong link to dry eyes. Estrogen may be beneficial to menopausal and postmenopausal patients with dry eye syndrome. The decision to use systemic estrogen should be made after a patient has been diagnosed as having an estrogen deficiency with due consideration for all other potential side effects.

Cyclosporine

In cases where a patient displays dry eye symptoms prior to LASIK , some patients are now being treated with cyclosporine 0.05% pre and post-operatively. Preoperative treatment requires that the patient use the cyclosporine twice a day for a month. Then they go back on the cyclosporine within 24 hours of surgery.


E-mail this page to a friend   
Enter your friend's e-mail address  :

PLEASE NAVIGATE THIS SITE BY USING THE LINKS PROVIDED ON OUR  SITE MENU ON THE HOME PAGE
PRK and LASIK Today - www.lasik1.com Worldwide Directory What is LASIK?  What's New
PRK and LASIK Today - www.prk.com
Price/Payment Options/Patient Financing FAQs
Free Information Medical Section Glossary

For more information contact:
Dr. Murray McFadden
(BSc, MD, FRCS(C), Diplomate of the
American Board of Ophthalmology)
© Copyright 1996-2005 Murray McFadden MD, Inc.

Email: m2@lasik1.com
Telephone: (604) 530-3332
Fax: (604) 535-6258
SnailMail: 20434 64th Avenue, Unit #201,
Langley, BC Canada V2Y 1N4


This page last updated on September 24, 2001.
Web Page Programmer Turnaround Type and Graphics

Disclaimer
Murray McFadden MD., Inc. provides Online information by way of Internet for communication and review purposes only. Murray McFadden MD., Inc. does not have editorial control over and has not participated in the development of the materials provided here, other than those materials copyrighted in favour of Murray McFadden MD., Inc. himself, nor has Murray McFadden MD., Inc. exerted any control or participated in the development of other Internet sites which may contain informational materials of a similar nature to those found here. Murray McFadden MD., Inc. disclaims any and all liability for any injury or other damages which may result from the communication or review of information contained here.

Materials produced here are not intended to provide medical information. Rather, the materials are presented for informational purposes only. None of the materials presented may be relied upon by any person for any medical, diagnostic or treatment reasons whatsoever. None of the materials presented here may be relied upon by any person for purpose other than informational purposes without the express written consent of Dr. Murray McFadden or the person indicated as the owner of the relevant materials. Dr. Murray McFadden disclaims any liability for any injury or other damages resulting from the review or use of the information obtained here. Dr. Murray McFadden asks that any person reviewing the materials presented here obtain specific medical advice and answers to specific medical questions, by a qualified eye doctor.