Dry Eye Syndrome; Treatment.
The mainstays of dry eye treatment are over-the-counter artificial tears in the form of eye drops. Health care professionals generally recommend you use them as often as needed to relieve symptoms. How often you use the drops can depend upon how bothersome your symptoms are, how dry your immediate environment is, and even how humid the weather is. Some patients with dry eye may find that on a rainy day, they need only a drop of artificial tears for the entire day. On a dry, sunny and windy day, they may use a drop every hour.
Artificial tears primarily provide symptomatic relief and do not address the underlying causes of dry eye disease; however, they may be adequate for treating mild or episodic dry eye. Further, they are a "foundation" therapy for all levels of severity and are recommended as a treatment component as additional therapies are added.
An often-recommended brand of artificial tears is Refresh. The family of products includes Refresh Tears and Refresh Plus, for mild to moderate dry eye, Refresh Liquigel and Refresh Celluvisc for moderate to severe dry eye and Refresh P.M. for nighttime use. These products provide quick, temporary relief from symptoms. Two newer formulations, Refresh Endura (preservative-free tears) and Refresh Dry Eye Therapy (preserved artificial tears), can help to maintain lasting comfort and complete dry eye relief over time. Refresh Endura and Refresh Dry Eye Therapy have been demonstrated as effective in eliminating moderate to severe eye dryness. These are the first products for dry eye that treat all three layers of the tear film: They deliver oil to the tear's lipid layer (to minimize evaporation); water to the tear's aqueous layer (to keep the eyes wet); and an ocular lubricant to the tear's mucin layer (to keep the cornea lubricated).
If you are using artificial tears frequently but find they don't seem to relieve symptoms, the preservatives in the drops may be irritating the eye, or creating an allergic reaction. In such cases, preservative-free eye drop brands may be better for you. Refresh Plus is an artificial tear that mimics the soothing properties of natural tears, but is a preservative-free formulation recommended for mild to moderate dry eye. For more serious dry eye, your provider may recommend Refresh Celluvisc, a preservative-free lubricant formula used for long-lasting relief and protection.
Over-the-counter sterile eye ointments, such as Refresh PM, sometimes are recommended for nighttime use to help prevent the eye from drying out, and to treat the scratchy eye feeling that many dry eye sufferers have when they wake up.
Restasis (cyclosporine ophthalmic emulsion cyclosporine ophthalmic emulsion
Sandimmun (UK), Restasis
Pharmacologic class: Polypeptide antibiotic
Therapeutic class: Immunosuppressant
Pregnancy risk category C
FDA Boxed Warning0.05 percent) is the first and only U.S. Food and Drug Administration-approved treatment for patients with the tear deficiency of keratoconjunctivitis sicca (or dry eye disease), whose tear production is presumed to be suppressed due to ocular inflammation. Its primary ingredient is cyclosporin A, an immunosuppressive agent used in organ transplantation. The anti-inflammatory effect of topical cyclosporin A improves overall tear function and/or production and restores mucin production by goblet cells. Restasis should not be used by patients with active eye infections.
As a general rule, if you use artificial tears more than two times a day for dry eye symptoms, you should visit an eye health professional to discuss additional treatments.
Bensinger, R, MD, FAAO FAAO,
n.pr See Fellow of the American Academy of Osteopathy. , spokesman for the American Academy of Ophthalmology, and chief of ophthalmology at Swedish Hospital, Seattle, WA. Direct interview. Nov. 6, 2000.
"Dry Eye Syndromes, Your Questions Answered." The Schepens Eye Institute, Harvard Medical School Harvard Medical School (HMS) is one of the graduate schools of Harvard University. It is a prestigious American medical school located in the Longwood Medical Area of the Mission Hill neighborhood of Boston, Massachusetts. . http://www.eri.harvard.edu. Accessed Sept. 2002.
"Fact Sheet: The Cornea and Corneal Disease." National Eye Institute. http://www.nei.nih.gov. June 2001. Accessed Sept. 2002.
"Frequently Asked Questions About Dry Eye." Prevent Blindness America. http://www.preventblindness.org. Updated May 2003. Accessed Sept. 2003.
"Hydroxypropyl Cellulose (Ophthalmic)." Medlineplus Health Information, National Library of Medicine. Updated Sept. 2002. http://www.nlm.nih.gov. Accessed Sept. 2002.
Petrauskas, JL, MSPH MSPH Mailman School of Public Health (Columbia Universty, New York City)
MSPH Master of Science in Public Health
MSPH Mrs. Potato Head (toy) . "Digging in the Ocular Desert." EyeNet Magazine Online. American Academy of Ophthalmology. http://www.aao.org. July 2000. Accessed Sept. 2003.
"Studies Show Promise for Drug to Treat Dry Eye Syndrome dry eye syndrome Conjunctivitis arida, keratitis sicca, keratoconjunctivitis sicca, xerophthalmia Medtalk Dryness of eyes, often due to ↓ tear secretion Clinical Dry, greasy, thickened and focally denuded cornea, which may progress to keratomalacia, corneal ." American Academy of Ophthalmology. http://www.medem.com. News release April 11, 2000. Accessed Sept. 2002.
"Dry Eye Syndrome" EyeMDLink. Updated Oct. 2001. http://www.eyemdlink.com. Accessed Sept. 2002.
Relating to the conjunctiva.
pertaining to or emanating from conjunctiva.
congenital conjunctival membrane Histologic Findings of Dry Eye and Non-Dry Eye Contact Lens Wearing Subjects" The CLAO CLAO Contact Lens Association of Ophthalmologists
CLAO Council of Lebanese American Organizations
CLAO Cahiers de Linguistique - Asie Orientale
CLAO Church Library Association of Ontario
CLAO California Legislative Analyst's Office Journal. Jan. 2001. http://www.clao.org. Accessed Sept. 2002.
Cross WD et al. "Clinical and Economic Implications of Topical Cyclosporin A for the Treatment of Dry Eye." Managed Care Interface. Vol. 15 (9): 44-9. Sept. 2002.
Sullivan DA et al. "Androgen Deficiency, Meibomian Gland Dysfunction, and Evaporative Dry Eye." Annals New York Academy of Sciences The New York Academy of Sciences is the third oldest scientific society in the United States. An independent, non-profit organization with more than 25,000 members in 140 countries, the Academy’s mission is to advance understanding of science and technology. . Vol. 966: 211-22. June 2002.
"LASIK LASIK laser-assisted in-situ keratomileusis.
Eye surgery in which the surface of the cornea is reshaped using a laser, performed to correct certain refractive disorders such as myopia. Safe, Effective in Patients With Dry Eyes" Medscape Medical News. Aug. 16, 2002. http://www.medscape.com. Accessed Sept. 2002.
"Hormone Replacement Therapy Hormone Replacement Therapy Definition
Hormone replacement therapy (HRT) is the use of synthetic or natural female hormones to make up for the decline or lack of natural hormones produced in a woman's body. and Dry Eye Syndrome" JAMA. Vol. 286 No. 17, Nov. 7, 2001. http://jama.ama-assn.org. Accessed Sept. 2002.
"New Dry Eye Therapy Launched" Sjogren's Syndrome Foundation. 2003. http://www.sjogrens.com. Accessed Sept. 2003.
Schaumberg DA, et al. "Prevalence of Dry Eye Syndrome Among US Women" Aug. 2003. American Journal of Ophthalmology, 136:2 : 318-326.
Market Scope. Report on the Global Dry Eye Market. St. Louis, Mo: Market Scope, July 2004.
"Dry Eye Fact Sheet." The Schepens Eye Institute, Harvard Medical School. http://www.theschepens.org. Accessed June 2006.
Keywords: dry eye syndrome, artificial tears, over-the-counter, treatment