Many people need and use treatments for dry eyes. Perimenopausal women, patients with Keratoconjunctivitis Sicca, and others get dry eye symptoms. Dryness of the eyes can manifest in different ways.
Usually people with dry eyes will complain of feeling grittiness, scratchiness or feeling that something is in the eye. Occasionally one may experience just a general irritation or stickiness of the eyes without any discharge. Epiphora, or excessive tearing, is also a common complaint signaling dryness of the eyes.
Dry Eye Medications
Typically the symptoms of dry eyes can be treated with the frequent use of artificial tears. Artificial tears come in a preserved form and also in a preservative-free form for those people with preservative allergies or with sensitive eyes. Either kind may be purchased at most chemists without a prescription.
Endura Tears is a type of artificial tear. It is composed of capsules that contain different substances which help replenish all three layers of the tear film — aqueous, lipid, and mucin layers — instead of just the aqueous layer. This artificial tear is also available without a prescription.
Restasis is a cyclosporine ophthalmic emulsion that can be used for severe dry eyes. It is unique because it helps control the inflammation that causes dry eyes and does not just treat the symptoms of this condition, as artificial tears do. Restasis is thought to increase tear quality as well as tear quantity.
Restasis is contraindicated in patients with a history of herpetic disease. It is to be used twice a day to start and may eventually be tapered in some people. Anybody with dry eyes who is interested in finding out if they are a candidate for the use of Restasis, they should contact an ophthalmologist as soon as possible.
Punctal Plugs
Sometimes patients with dry eyes do not get enough relief from artificial tears, even if used several times per day. An alternative treatment to using artificial tears is having punctal plugs inserted.
If one’s eyes develop normally, a small hole, called a punctum (plural-puncta) forms in the nasal corner of both upper and lower eyelids. Our tears drain into the puncta in both eyes, then into a duct (the nasolacrimal duct) that empties into each nostril.
Punctal plugs are inserted into one or both puncta depending on the severity of dry eye. The plug prevents the tears from draining down into your nasolacrimal duct. Therefore, your natural tears stay on your cornea longer, keeping the eyes more moist. This allows one the freedom of not having to use the artificial tears as often, or at all in some cases.
Usually a trial of punctal plugs can be performed by inserting a plug made of collagen which dissolves after only a few days. If this temporary plug helps decrease dry eye symptoms, then a more permanent silicone plug can be placed. Of course, if there is any discomfort experienced with the silicone plug, it can be removed at any time by the ophthalmologist.
If the silicone plugs work well enough, and one does not want to risk these plugs falling out, then the ophthalmologist can permanently close the puncta with cautery — an in-office procedure.
Dr Eileen Conti is a board certified and cornea fellowship trained ophthalmologist. She does general ophthalmology, as well as medical and surgical treatment of glaucoma, cataracts, and corneal disease including dry eyes.
