Tuesday, September 21, 2021

Are Eye Drops Enough? - Best Treatment Options for Dry Eyes

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Do you feel your eyes are often red, scratchy, and tired from time to time? You may even notice your vision gets blurry sometimes. If so most likely you are suffering from dry eye disease.

We are often told to use over-the-counter artificial tears eye drops to treat dry eye disease. But are those eye drops enough for you? What are the additional dry eye treatment options when the over-the-counter drops are just not enough?

In today's article, We will go over the dry eye treatment options that target different causes of dry eye disease. The treatment options that I mention in this post are based on my own personal clinical experience. If your eyes are controlled with otc eye drops alone, I have written an article about my top five eye drops to help you to find the right one for you to treat dry eyes disease. Click here

Best Treatment Options for Dry Eyes

To understand which dry eye treatment options are right for you, It is important to understand what types of dry eye disease you have. There are three main types of dry eye diseases
  1. Evaporative type
  2. Aqueous Deficient type
  3. Mixed type
There are three different layers of the tear film;
  1. Lipid layer
  2. Aqueous layer
  3. Mucin layer
And each of the three types of dry eye disease is caused by a problem with one of the three different tear film layers.

1. Evaporative Dry Eye Treatments

The evaporative type of dry eye is mainly due to problems with the lipid layer tear film, which is the most outer layer. Often the tear film is unstable and evaporates too quickly when the lipid layer is unhealthy. With evaporative type, the eyes feel dry and irritated shortly after applying over-the-counter eye drops and you may feel that you need to put in eye drops over and over again.

The lipid layer of the tear film is secreted by the meibomian glands located in both upper and lower eyelids. If the meibomian glands are clogged or not working or the gland oil contains too many inflammatory particles. The aqueous layer of the tear film underneath, secreted by the tear glands will not remain on the cornea for long enough to lubricate and moisturize the eyes.

One effective treatment you can do at home to open up the oil glands is warm compresses. You can either just use a washcloth soak under hot water and ring it out and place it over closed eyelids for about five minutes once or twice a day, or you can use a heat mask. You can microwave most heat masks for 20 seconds and they will stay hot for 20 minutes. The heat will help open up the clogged oil glands.


For more severe blockage of the meibomian gland, you may ask your eye specialist about some in-office treatment options, such as ilux or lipid flow. They work like a more intense warm compress and are administered in the doctor's office to aggressively target clogged oil glands.

The evaporative dry eyes can also be caused by unhealthy gland oil secreted by the meibomian gland. This is typically due to increased inflammatory particles in the tear film.

In this case, it is important to modulate and restore the health of the meibomian glands and their oil. This is where omega-3 supplements can come into play. Because omega-3 supplements are not prescription medication and are not regulated by the FDA.

Their dosage and composition may vary greatly. Please remember to always consult with your doctor before taking any high-dose omega-3 supplements to make sure if they are safe and right for you.

2. Aqueous Deficient Dry Eyes Treatment

The second type of dry eyes disease is the aqueous deficient type. This type of dry eye affects the aqueous layer of the tear film, which is made by the tear gland.

When the tear gland does not produce enough tears, the surface of the eye or the cornea, which is the clear dome-shaped structure that functions as the windshield of our eyes, does not get adequately lubricated and moisturized.

This type of dry eye disease needs to be treated with artificial tears eye drops. A lot of times inflammation of the tear gland and the surface of the eye causes decreased tear production and low tear turnover.

your eye doctor may prescribe a mild steroid eye drop for a short period of time to decrease the inflammation on the surface of the eye and to improve tear production.

Prescription eye drops containing steroids can have side effects I used long-term such as cataract formation and increased eye pressure. This is why steroid prescription eye drops are typically only used for a short period of time. There are three FDA-approved prescription eye drops that do not contain steroids.
  1. Sodium Hyaluronate eye drops
  2. Xiidra eye drops
  3. Cequa eye drops
These drops have good efficacy and safety profile and can be used long-term to treat dry eye disease. The three eyedrops each work differently and it is important to discuss with your eye doctor.

Sometimes your eye doctor may consider placing plugs in your tear ducts to keep the tears in your eyes longer. For people who suffer from a severe aqueous deficient dry disease such as Sjogren's disease, even the treatment options I just mentioned may not be enough.

In those cases, a special type of eye drop purified from the patient's own blood can be used to treat the disease and control the symptoms. They are called autologous serum eye drops. Your eye physician or cornea specialist can help you determine if your disease is severe enough to need serum drops.

3. Mixed type Dry Eyes Treatment

The last type of dry eye disease is the mixed type of dry eyes, and this is probably the most common type of dry eye disease. For a lot of people with dry eyes, both the lipid layer and the aqueous layer of the tear films are unhealthy.

People with a mixed type may need a combination of the dry treatments that I mentioned earlier such as warm compresses and omega-3 oil supplements to improve the oil gland function.

Otc artificial tears eye drops and prescription medications to control dry eye symptoms. It is important to remember there is no one size fits all treatment protocol for everyone.

In my clinical practice, I make an individualized treatment protocol for each patient, based on their individual situation and I tailor their treatment plan based on their response to each treatment option.

In this blog post, I have mentioned some of the common dry eye treatment options. There are also other, more invasive, and advanced treatment options that are typically reserved for extremely severe cases.

The dry disease is more common than we often think and it is estimated that more than 16 million people in the US suffer from dry eye disease.

If you feel your eyes are still irritated or sometimes have blurry vision, despite using over-the-counter eye drops. It is important to have a full eye exam and talk to your eye doctor about what treatment options are right for you.

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