Managing Dry Eyes

Dry eyes (Keratoconjunctivitis sicca) can be a debilitating condition. It can range from very mild to extremely severe. Everyone who suffers from eye dryness, either mild or otherwise, will tell you how time-consuming, irritating and life changing it can be. There are a multitude of ways to help Keratoconjunctivitis sicca but at the moment there is no cure. Depending on the type of dry eyes will also depend on the treatment. This is why seeing an eye doctor who specialises in dry eyes is very important. As some types of eye dryness can be a secondary to other health problems, it is always best to have a thorough consultation with an eye specialist to determine the right treatment for you.

Initially we need to find out what type of dry eyes you have. This is done by an eye doctor performing tests but more so from listening to your experience and symptoms. It is also important for your eye doctor to learn as much as possible about your health and lifestyle as this can heavily affect the tear film health. Tears are made up of 3 parts; mucous layer, aqueous (watery layer) and oil layer. If one of these parts is missing, you will suffer with some form of Keratoconjunctivitis sicca. Once we are aware of what part is missing we can then move on. There are 4 levels of managing dry eyes after diagnosis. We start at level 1 and keep moving on if the previous level is not working well.

Level 1:

  • we must educate on environmental or dietary modifications as this can have a big impact on sufferers with eye dryness.
  • we must also eliminate any medication that is causing the dryness such as antidepressants or antihistamines and review contact lens wear if necessary.
  • use preserved artificial tears, gels or ointments and try eyelid therapy such as massage and cleaning.

Level 2 Added (if level 1 is not adequate):

  • non – preserved artificial tear film replacements.
  • anti – inflammatory agents.
  • tetracyclines for meibomian gland dysfunction or rosacea.
  • punctal plugs once inflammation is controlled.
  • secretagogues, which is a substance which promotes secretion.
  • moisture chamber goggles.

Level 3 Added (if level 2 is not adequate):

  • autologous serum or umbilical cord serum.
  • contact lenses.
  • permanent punctal plugs.

Level 4 Added (if lever 3 is not adequate):

  • this consists of the administration of systemic anti-inflammatory agents such as cyclosporine.
  • there are also a variety of surgeries that can help with dry eyes but this would be a last resort.

If you suffer from dry eyes or think you may have dry eyes please book an appointment with your eye doctor, eye specialist or optometrist for a thorough assessment.