Chronic dry eye treatments range from eye drops to surgical procedures. Lifestyle changes, natural remedies, and alternative therapies may also help.
Dry eye occurs when your eyes can’t produce enough tears. This might be because your tears evaporate too quickly or due to inflammation in or around the eye.
You can experience temporary dry eye from environmental factors, like wearing contact lenses for too long or being in a dry environment. But chronic dry eye is an ongoing condition. Your symptoms may get better or worse but never go away completely.
Chronic dry eye is often due to an underlying condition. Conditions involving the eyelids, skin diseases near the eyes, nutritional deficiencies, and allergies can all contribute to chronic dry eye.
There are many options for treating dry eye, so you can find one or more that work for you.
There are many medications available to treat chronic dry eye.
Sometimes, an underlying condition or external factor may lead to dry eye, so it’s best to contact a doctor to rule out any other conditions. Some medications can also cause dry eye, so you may simply need to work with your doctor to switch medications.
Over-the-counter (OTC) medication
One of the most popular ways to treat dry eye is through OTC eye drops, also called artificial tears.
Preservative-based eye drops stay on the shelf for a long time. Preservative-free eye drops come in several disposable vials you use once and throw away.
Artificial tears moisten your eyes and may be enough to relieve moderate dry eye symptoms. Still, you may need to apply them several times a day.
You can also use ointments, but they tend to make vision cloudy. Ointments coat your eyes better than eye drops do. Because they make vision blurry, it’s best to use them right before bedtime.
Avoid using eye drops that reduce redness. These may eventually irritate your eyes because they constrict blood vessels.
If regular OTC tear replacement drops don’t work, eye inserts might be an option. Made of dissolvable cellulose, they look like flattened grains of rice and rest deep behind the lower eyelid.
You place the inserts in the space between your eyeball and lower eyelid. The insert releases medication throughout the day to keep your eye moist.
A doctor may prescribe medication to treat chronic dry eye. This could include prescription eye drops or medications you take orally (by mouth).
Most of these focus on reducing inflammation on the surface of your eye and the margins of your eyelid. When your eyelids are inflamed, they prevent your oil glands from adding oil to the outer layer of your tear film. Without oil, your tears evaporate too quickly.
Certain antibiotics stimulate oil production in the glands around the eyes. If a doctor believes inflammation is primarily causing your dry eye, they may prescribe anti-inflammatory antibiotics.
Prescription eyedrops are often anti-inflammatory as well. Common options include:
What’s the latest treatment for dry eye syndrome?
As of 2023, the most recent eye drops approved to treat dry eye is perfluorohexyloctane (Meibo). It helps to reduce the evaporation of tears.
If your chronic dry eye is due to losing tears too quickly, you may find relief by wearing special contact lenses. These help protect the surface of your eye and prevent moisture from escaping.
Scleral lenses are custom-made lenses that protect the entire surface of your eye and help it retain moisture.
In addition to medications, a doctor might recommend certain procedures to treat chronic dry eye. These include:
- Tear duct plugs: For moderate to severe dry eye, a doctor may insert
punctal plugsto partially block your tear ducts. These removable silicone or gel plugs help tears stay in your eyes longer.
- Intense pulsed light (IPL) therapy: IPL uses pulses of light to treat inflammation and clear blockages in your eyes’ oil glands. But the effects may wear off after
- Thermal pulsation: Thermal pulsation is done to clear blocked oil glands by applying heat to your eyelids, followed by pulsating pressure. The treatment takes about
- Amniotic membrane graft: An
amniotic membrane graftuses a thin layer of preserved human placenta to help repair the surface of your eye.
- Surgery: In
rare cases, a doctor might recommend surgery to permanently close your tear ducts or adjust your eyelids to help retain tears.
Several natural treatments may help chronic dry eye. Examples include:
- Warm compress: Hold a warm, wet cloth over your eyes for 5 minutes to reduce dry eye symptoms.
- Mild soap: Massage your eyelids with a mild soap, such as baby shampoo. Close your eyes, apply the soap with your fingertips, and gently massage your eyelids.
- Omega-3 supplements: Though
research is mixed, some evidence suggests that omega-3 fatty acids may help relieve dry eye symptoms. You can get these through your diet by eating foods like flaxseed, salmon, and sardines. You can also take supplements like fish oil or use omega-3 eye drops.
- Castor oil eye drops: Castor oil may help reduce tear evaporation, improving your symptoms. Artificial tear eyedrops that contain castor oil are available.
Always talk with a doctor before trying any natural remedy.
Researchers continue to explore several
Alternative therapies include:
- Acupuncture: Acupuncture may help relieve dry eye symptoms by affecting nerve function. A
2019 studyfound that acupuncture could be an effective add-on to traditional treatments.
- Transcutaneous electrical nerve stimulation (TENS): A TENS unit may help stimulate nerves that help induce tears.
- Stem cells: Stem cells
may helprepair the inner surface of your eyelids or your tear and oil glands. But more human studies are needed.
The authors of a
You can make some at-home changes that may improve your chronic dry eye symptoms.
- wearing sunglasses with side shields to prevent tears from evaporating
- including proper eyelid hygiene — like eyelid scrubs — as part of your daily routine
- blinking often when doing a repetitive task for a long time, like reading or looking at a screen
- using a cool mist humidifier to add moisture to the air
- drinking water throughout the day to stay hydrated
- avoiding smoke by not smoking and limiting your exposure to secondhand smoke
Treating chronic dry eye involves either producing more tears or conserving the tears you make. Conventional first-line therapies include eye drops and oral antibiotics. More severe cases may require special lenses or a medical procedure.
How you and a doctor choose to treat your symptoms will depend on several factors, including:
- the severity of your symptoms
- the cause of your dry eye
- whether there is an underlying condition
- what you’re comfortable with
Work with your doctor or an eye specialist to find the best solution for you.