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Treatments for Chronic Dry Eye

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

Dry eye can be a temporary or chronic condition with many causes. In either case, your doctor can help you find ways to reduce your symptoms.

But you don’t always have to rely only your doctor. Many people have had success with natural remedies performed at home. The treatment you choose for your chronic dry eye is up to you. And your choice depends on how much relief you need and how convenient you want your treatment to be.

What is chronic dry eye?

When a condition is referred to as “chronic,” it means it has gone on for a long time. Usually symptoms get better or worse, but never go away completely. For most chronic conditions, treatments have been developed to help patients feel well enough to enjoy daily life.

Chronic dry eye occurs when your eyes cannot produce enough tears. This may be because your tears are evaporating too quickly. It can also be due to inflammation in or around the eye.

Temporary dry eye is often caused by environmental factors. You may see symptoms from wearing contacts too long or being in a dry environment. Chronic dry eye, on the other hand, is often caused by an underlying condition.

Conditions involving the eye glands, skin diseases near the eyes, and allergies can all contribute to ongoing dry eye.

Fortunately, there are many ways to treat dry eye even when it is chronic.

Prescription treatments

There are lots of prescription drugs for dry eye. Most of them focus on reducing inflammation of your eyelids. When your eyelids are swollen, they prevent your oil glands from getting oil into your tears. Without oil, your tears evaporate too quickly.

You should pay attention to your lifestyle and determine if there is something external causing your dry eye. For example, some medications can cause dry eye.

Medications

A doctor may prescribe different kinds of oral medications to treat dry eye. One way is through antibiotics. There are certain antibiotics that have been found to stimulate oil production in the glands around the eyes.

These medications may be given orally or as eye drops. If your doctor believes your dry eye is caused primarily by inflammation, they may prescribe anti-inflammatory antibiotics.

Another oral medication that may be prescribed is called cyclosporine. Cyclosporine is also used to treat patients with rheumatoid arthritis and psoriasis. This drug suppresses the immune system so that the body stops attacking itself. Cyclosporine comes either as a capsule or liquid, and works by preventing inflammation.

Eyedrops

A common treatment for chronic dry eye is eyedrops. Prescription eyedrops are often anti-inflammatory. Cyclosporine may also be administered through eyedrops for this purpose.

Anti-inflammatory eye drops decrease inflammation on the eye’s surface so that tears stay in your eyes longer. Over-the counter (OTC) eye drops, on the other hand, are usually just artificial tears.

Eye inserts

When regular OTC tear replacement drops don’t work, eye inserts might be an option. These small, clear tubes of medication look like grains of rice and go into your eye like contacts.

You place the inserts in your eye between your eyeball and lower eyelid. Medicine is released throughout the day to keep your eye moist.

Procedures for chronic dry eye

In addition to prescription and OTC medications, certain procedures may be used to treat chronic dry eye.  

Closing tear ducts

It may be appropriate to have your tear ducts closed. If your chronic dry eye doesn’t respond to traditional methods, your doctor may recommend this procedure. The idea is that tears will stay in your eyes longer if there is nowhere for them to drain.

Special contacts

You may find relief from chronic dry eyes by wearing scleral or bandage contact lenses. These special contacts are designed to protect the surface of your eye and prevent moisture from escaping. This option is helpful if your chronic dry eye is caused mainly by losing tears too quickly.

Dealing with oil glands

Your doctor may recommend a procedure known as LipiFlow thermal pulsation. The technique involves placing a small cup over your eye. And then warm water flows over the eye for 15 minutes. The idea is to clear a blocked oil gland.

Alternative treatments

Prescriptions aren’t the only way to treat chronic dry eye. Just as with temporary dry eye, there are things you can buy at the store to help. You can also change your habits or use natural alternatives to treat this condition.

Over-the-counter drugs

One of the most popular ways to treat dry eye is through OTC eye drops, called artificial tears. Preservative-based eye drops stay on the shelf for a long time. Nonpreservative eye drops come in several disposable vials that you use once and throw away.

Artificial tears simply moisten your eyes. If you have moderate symptoms of dry eye, even if it is chronic, artificial tears may be all you need. However, you may have to apply them several times a day.

Ointments can also be used, but they tend to make vision cloudy. Ointments coat your eyes better than eye drops do. However, because they make vision blurry, they are best used right before bedtime.

Avoid using eye drops that reduce redness. These may eventually irritate your eyes because they constrict blood vessels.

Natural remedies

There are several natural alternatives that may help chronic dry eye.

  • Intense-pulsed light therapy, for example, has been used with positive results if you have oil gland problems.
  • A warm, wet cloth held over your eyes for five minutes may reduce dry eye symptoms.
  • Alternative treatments like fish oil supplements, castor oil eye drops, and acupuncture may also relieve dry eye.

Lifestyle changes

There are some at-home treatments that may improve your chronic dry eye symptoms. These include

  • wearing sunglasses with side shields to prevent tears from evaporating
  • blinking often when doing the same task for a long time, like reading or looking at a computer
  • using a cool mist humidifier to add moisture to the air
  • drinking water throughout the day to stay hydrated

Which treatment is best for you?

Deciding which treatment to seek for your chronic dry eye depends on a variety of factors. For one, what does your doctor say? If your dry eye is caused by an underlying condition, such as a gland disorder, treatment for this may be prescribed.

If your symptoms are mild you may want to seek less aggressive treatment. If you don’t mind applying artificial tears throughout the day, that may be all you need.

Keep in mind that the more severe your symptoms are, the more aggressive your treatment might be. In some cases, having a procedure to get your glands closed might be the best option. It just depends on your doctor’s opinion, what you are comfortable with, and how severe your symptoms are.

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