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Switching Dry Eye Treatment: What You Need to Know

Medically reviewed by Judi Marcin, MD on August 24, 2016Written by Sonia Pearson on August 24, 2016

It’s fine to use over-the-counter (OTC) medications to treat dry eyes, as long as they work. But if your symptoms get worse, your OTC medicine might not be performing. If this happens, it may be time to switch over to prescription medication.

Several options are available to treat dry eyes by prescription. Your doctor can talk with you about which medication is best. It all depends on what’s causing your dry eyes.

Causes of dry eyes

Dry eyes can be caused by a number of factors. There are two main types of dry eyes:

  • lack of tears
  • poor quality tears

Tear production depends on the tear film, which is made up of water, mucus, and oil layers. Your eyes need all three of these layers to adequately produce fluid.

When the water layer malfunctions, the result is eyes that can’t produce enough tears. When the oil layer malfunctions, lack of oil secretion results in tears that evaporate too quickly.

A number of things contribute to dry eyes, and you may experience just one or several of them. These may include:

  • being exposed to a smoky or dry environment
  • looking at a book or screen for too long without blinking
  • taking medication that dries up your eyes
  • experiencing estrogen fluctuations caused by age

You may also have another medical condition like rheumatoid arthritis, lupus, diabetes, or a gland disorder that causes dry eyes.

Whatever the cause of your dry eyes, if OTC medications aren’t helping you anymore, it’s time to ask your doctor for help.

Treatments for dry eyes

The goal of any dry eye treatment is to make sure tears stay in the eyes. There are a variety of options available that include:

  • anti-inflammatory drugs, such as cyclosporine, which reduce inflammation of the eyelids and oil glands
  • eye inserts, which are used daily and sit in the space between your lower eyelid and eyeball and release lubricating tears throughout the day
  • drugs such as pilocarpine that stimulate tears and come in pill, gel, or eyedrop form
  • blood-based eyedrops, which are made from your own blood serum, and serve as a last resort for some people
  • plugging or blocking tear ducts to prevent tears from draining
  • special contacts that cover more of the eyeball and trap moisture
  • thermal pulsation treatment to unblock oil glands
  • light therapy and eye massage to open the oil glands

With all these treatment options, it’s no wonder you need a doctor to help you narrow them down. Switching from OTC artificial tears to a prescription for reducing inflammation may be a good place to start.

How to know you need to switch treatment

It’s usually easy to recognize when one treatment stops being effective. Take note of how you are using your OTC treatment. For example, do you apply artificial tears all day long but find no relief?

Your dry eyes may require more specialized treatment. This can be achieved through a prescription to stimulate tear production or correct an oil gland problem.

You could also try treatments at home before seeking medical help. Increasing your intake of omega-3 fatty acids may reduce dry eye symptoms. You can also try a warm compress or mild soap to open a clogged oil gland.

Or you might try OTC ointments, which can make vision blurry and are best applied at bedtime.

What happens when you change treatment?

When you visit a doctor about your dry eyes, they might ask you about your symptoms. And they will usually ask what you’ve been doing to treat your condition. Be honest about everything you’ve tried.

When your doctor prescribes a new medication, follow your doctor’s directions carefully. Make sure you ask your doctor and pharmacist how to take the new medication and about possible side effects.

When you need to talk to a doctor

Keep your doctor informed about how you’re doing. If your new treatment doesn’t seem to be helping, tell your doctor. And if you experience any new symptoms or side effects, tell your doctor right away.

For example, if you’re taking anti-inflammatory eyedrops, tell your doctor if you have an allergic reaction. You may experience symptoms of anaphylaxis like hives, swelling, or a closed throat. These side effects are rare, but they can be serious.

Another sign you need to see your doctor about your dry eyes is if your symptoms get worse. This means that your prescription medication is not working, and your doctor will need to look closely at your eyes and tears again. You may have an underlying condition that was not identified before.

Takeaway

The question of switching to a prescribed medication or treatment depends on whether your symptoms are getting worse. And whether it’s getting harder and harder to focus at school or work.

Look at your life situation and eliminate environmental things that affect dry eyes. Consider adding a cool mist humidifier at home or wearing sunglasses with side shields. Both of these options can keep tears from evaporating.

And talk to your doctor if your current treatment isn’t working or if your symptoms get worse.

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