There are many treatment options for Chronic Dry Eye, and depending on the cause of your Dry Eye, the treatment or combination of treatments prescribed can vary by patient. The majority of Dry Eye sufferers have Meibomian Gland Dysfunction (MGD); thus, treatment of MGD should focus on and include clearing blockages in the Meibomian glands.
Less commonly, Dry Eye can be caused by reduced tear production. This affects a smaller proportion of the population; however, some patients may have both MGD and reduced tear production. Treatment for reduced tear production may require the use of a prescription medication in the form of an eye drop, tear replacements, punctal plugs are other therapy.
Consult your eye care professional to determine if you have MGD or other causes of dry eye and the treatment options that are best for you. Ask your doctor about the role of various environmental factors that may increase or decrease your visual comfort.
Listed below are various Dry Eye treatment options. Some of them will treat the cause of MGD or dry eye and may only need to be administered occasionally (e.g. yearly or less frequently). Others may only offer a short-term solution and require frequent use (e.g. daily).
LipiFlow is the only FDA-cleared in-office, inner lid treatment for Meibomian Gland Dysfunction (MGD). The patented device designed and manufactured by TearScience, uses a combination of precisely controlled heat and pressure to unclog blocked Meibomian glands. This is known as thermal pulsation. LipiFlow is designed to treat the leading cause of Dry Eye, MGD.
Currently there are two prescription medications (Xiidra™ from Shire™ and Restasis® from Allergan) approved by the FDA for the treatment of dry eye. There are currently no prescription medications approved by the FDA for the treatment of MGD. However, there are other prescription medications that may be prescribed for dry eye patients, such as in managing inflammation in the short term while the true cause of the condition is treated.
There are many over-the-counter artificial tear replacement drops widely available today. These drops are intended to provide lubrication for the eye. Artificial tear replacement drops have various ingredients, with low to high degrees of viscosity. In general, and depending on the severity of Dry Eye symptoms, a higher viscosity drop will stay in the eye longer before being washed out by the natural blinking mechanism and tear exchange.
Examples of eye drops brands on the market today are Systane® or GenTeal® manufactured by Alcon ®, Bausch & Lomb’s Soothe® or Advanced Eye Relief™ drops, Refresh® drops from Allergan™, Clear Eyes® from Prestige Brands and TheraTears® from Akorn Consumer Health as well as many others.
Another artificial tear replacement option is a small rod-shaped capsule that is placed on the inside of the eyelid and slowly releases lubrication over time. An example of this is Lacrisert®.
For centuries we have known that the application of heat to the outside of the eyelids can be helpful in keeping the meibomian gland oils less viscous. This can be beneficial in mild cases of Meibomian Gland Dysfunction, or MGD, and needs to be done daily or multiple times a day. It is considered supportive therapy for MGD. The most common example of applying heat to the outside of the eyelids is the use of warm compresses over the eyes.
Meibomian Gland Dysfunction (MGD) can be treated with manual gland expression. This is an in-office procedure where the doctor forcefully and “manually” squeezes clogged gland contents from the Meibomian glands. This procedure is typically repeated multiple times during the year.
Lacrimal or Punctal Plugs are small silicone or collagen gel inserts that are placed in the inner corners of the eyelid where the tears drain out. The plugs reduce tear drainage so that the tears stay on the eyes longer. Options include permanent plugs or semi-permanent plugs.
Natural supplements or dietary sources may be used as part of an overall care plan in conjunction with other treatments for MGD or dry eye.
These treatment options do not represent opinions, treatment comparisons, result claims or direct recommendations from the authors of this site, TearScience or any of its affiliates. Only a licensed eye care professional can make treatment recommendations.