Types of Dry Eye
There are two types of dry eye: (3)
Aqueous tear-deficient dry eye The eyes' lacrimal glands fail to produce enough of the middle aqueous layer of tears, resulting in low tear production.
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Evaporative dry eye The eyes meibomian glands don't produce a strong outer lipid layer of tears, resulting in tears that evaporate too quickly.
Tears also have a third component — an inner mucous layer — that is produced by goblet cells and allows the aqueous layer to spread evenly over the surface of the eye. (3)
In addition to dry eye syndrome, dry eye is also sometimes known as: (4)
- Keratoconjunctivitis sicca
- Dysfunctional tear syndrome
- Lacrimal keratoconjunctivitis
- Evaporative tear deficiency or aqueous tear deficiency
- LASIK-induced neurotrophic epitheliopathy
Treatment and Medication Options for Dry Eye
The right dry eye treatment often depends on the cause of your condition.
Over-the-Counter Options
For mild or occasional dry eye, artificial tears (dry eye drops) can help lubricate the eyes and relieve symptoms. The best part about artificial tears is that you don't need a prescription. (6) There are also a variety of options, including drops with electrolytes. These drops not only keep your eyes moist, but also protect the surface of your eyes. (7)
Alternatively, there are eye drops containing preservatives to prevent the growth of bacteria after you open the bottle, as well as nonpreservative eye drops. The latter has fewer additives. This is an option if you’re allergic to certain ingredients in eye drops, or if you apply artificial tears more than four to six times a day. (2,7)
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Prescription Options
While artificial tears are sometimes the first line of defense for dry eye, more severe symptoms require a prescription from your ophthalmologist or optometrist.
Talk to your doctor about the immune-suppressing drug Restasis (cyclosporine). This medication relieves dry eyes by stopping inflammation that interferes with tear production. (8)
Similarly, the prescription drug Xiidra (lifitegrast) can also adequately manage the condition, says Hauser. (3)
Or you may need to temporarily use corticosteroid eye drops to reduce inflammation. Antibiotic eye drops can also reduce eyelid inflammation, helping with the secretion of oil into your tears. (3,5)
A tear-stimulating drug (cevimeline or pilocarpine) is another option for improving symptoms of dry eye, or you might have excellent results with eye inserts that release a substance to increase lubrication. (5)
Surgery Options
Procedures that close the tear drainage holes in the inner corners of your eyelids — either temporarily (with tiny plugs) or permanently (with surgery) — may also be an option if you have dry eye. (2,5)
Closing your tear drainage holes allows the limited volume of tears to remain on your eyes longer.
Alternative and Complementary Therapies
If you prefer a natural approach to healing dry eye syndrome, consider acupuncture. A review of 19 studies found that acupuncture therapy combined with artificial tear therapy was more effective than artificial tear therapy alone for dry eyes, yet the individual study results varied. (5,9)
Home remedies, and making a few lifestyle changes, may also alleviate symptoms of dry eye.
If you take a prescription medication for another condition, check with your doctor to see if dry eye is a common side effect of this drug, says Fartash.
Improving dry eye symptoms may require switching to another medication, if possible.
You may also be better off wearing glasses if your contact lenses cause dry eye. (8)
In some people, consuming omega-3 fatty acids from supplements or foods (including fatty fish like salmon and sardines, as well as walnuts and flaxseed) reduces eye irritation, says Fartash. (2,8)
She also suggests using a humidifier to put moisture back into dry air, taking short breaks from technology to give your eyes a rest, and laying a warm, damp wash cloth across your eyelids for a couple minutes for relief. (2)
Prevention of Dry Eye
Here’s how else you can alleviate or prevent dry eye: (1,2,8)
- Wear wraparound glasses when outdoors to protect eyes from wind
- Blink often
- Don’t use a hair dryer
- Wash your eyelids with baby shampoo to help release oil into the eyes
- Remove makeup daily
- If you work on a computer, look away from the screen at least every 20 minutes
- Take an antihistamine to relieve allergy symptoms
- Drink 8 to 10 glasses of water per day to prevent dehydration
- Stop smoking
Contact Lenses and Dry Eye
With regard to contact lenses, dry eyes doesn't mean that you're no longer a candidate for contacts. But you’ll need to have a conversation with your doctor about dryness, and then choose a lens that’s comfortable to wear with this condition, such as single-use daily disposable lenses, advises Fartash.
The best contacts for dry eyes are soft lenses, as well as lenses with a low-water content, such as those made from silicone hydrogel. (10)
Complications of Dry Eye
If left untreated, complications associated with dry eye include eye inflammation and eye infections, especially if the cornea becomes damaged because of dryness. (1,6)
Conditions that can damage the cornea include corneal abrasions and corneal ulcers. Severe cases of dryness can also decrease vision, warns Fartash.
Another possible complication is conjunctivitis (pink eye), or inflammation of the conjunctiva, the mucous membrane that covers the white part of the eyes and inner surfaces of the eyelids. (6)
Depending on the severity, dry eyes can also reduce your quality of life. Blurry vision and sensitivity to light can make it hard to complete routine, everyday tasks such as driving and reading. (1) Dry eyes might also make it difficult to complete schoolwork, and your work performance could suffer.
Can Dry Eye Syndrome Cause Floaters?
If you have dry eye along with eye floaters, you might question the connection. While it’s not inconceivable to develop both eye conditions simultaneously, “floaters aren’t necessarily related to dry eyes, although both are common, especially as we age,” says Fartash.
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“Sometimes loose cells or fibers clump together within your eye fluid and cast a shadow onto the retina, which we see as floating dark specks or blobs known as eye floaters,” she explains. (11)
Above all, leaving dry eye untreated can disrupt your daily life, leading to a lower standard of living.
