Treatment

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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 0.05 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 to three times a day for dry eye symptoms, you should visit an eye health professional to discuss additional treatments.