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What Really Works to Treat Dry Eyes?

by Dr. Sharon Orrange on September 1, 2015 at 1:34 pm

Dry eyes are a common complaint as we get older, more common in women (due to hormonal changes) than in men. Dry eyes can cause redness, irritation, a gritty or burning sensation, excessive tears, light sensitivity, and blurred vision.
Most often dry eyes are a chronic condition requiring chronic treatment. Rarely, there is a specific reason for dry eyes that can be eliminated, like a medication or uncontrolled diabetes. This means you may be using artificial tears or eye drops indefinitely, and some treatments out there can add up quickly. Restasis made a whopping 1.4 billion dollars in the first half of 2015 alone. You may be wondering: is an expensive eye drop like Restasis worth it?
What causes dry eyes?
Dry eyes are classified into two groups: decreased tear production (less tears) and faster evaporative loss (the tears you do have disappear more quickly).

  • Decreased tear production can be caused by problems in the lacrimal (tear) gland leading to less tears—Sjogrens is one, but not the only, cause of this. Age-related dry eyes are caused by tear duct obstruction that occurs over time. This results in decreased tear production. Contact lens use and diabetes can also do this.
  • Increased evaporative loss means excessive water loss from the eye surface without any issue involving your tear duct. Increased tear evaporation is most commonly caused by something called posterior blepharitis (an eye doctor can diagnose this problem). Decreased blinking, allergies involving the eyes, and chronic contact lens use can also do this. An eye doc appointment will help sort this out.

What works for the treatment of dry eyes?

  • Artificial tears. These are the first-line treatment for dry eyes. There are many brands of artificial tears (Blink, Refresh) available without a prescription and they come in liquid, gel, and ointment forms. Preservative-free forms of these supplements are often recommended because some folks will have inflammatory reactions to the preservatives. Preservative-free artificial tears are more expensive though. One drop four times a day is the place to start and you may feel relief in a few days. Also remember that gels and ointments can blur vision because they are greasy.
  • Change your environment. Minimize exposure to air conditioning or heating. Humidifiers in your bedroom may also help.
  • Omega-3 and omega-6 fatty acids. A few good studies have shown that oral omega-3 and omega-6 fatty acids may improve symptoms of dry eye. In a study with TheraTears Nutrition omega-3 supplement, one 1200 mg capsule daily improved dry eyes. This is worth a try.
  • Acupuncture. It’s interesting to note that small studies have shown some improvement in dry eye symptoms following acupuncture therapy.
  • Restasis. Restasis is a brand name 0.05% emulsion of the immunosuppressant cyclosporine, available with a prescription for the treatment of dry eye disease. With Restasis, it may take up to six weeks or longer to see noticeable improvement of dryness. Most of my patients tell me they “think” it helped but couldn’t afford it. It is expensive, but give it a try if cheaper effective options haven’t helped. In some patients, Restasis can result in long term resolution of dry eye symptoms, but it’ll cost you.

Restasis, has it worked for you?
Dr O.

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