Dry Eye

What is dry eye disease?

Dry eyes occur when your eyes don’t produce enough tears to keep them properly
lubricated or when the quality of the tears is poor. This can lead to discomfort, redness,
itching, and a sensation of grittiness.

What are the types of dry eye disease?

There are a few different types of dry eye syndrome. The two main categories are
aqueous-deficient dry eye (not enough tear production) and evaporative dry eye
(increased tear evaporation). Additionally, there can be a combination of both types. It’s
important to consult an eye doctor for an accurate diagnosis and appropriate treatment.

How are different types of dry eye treated?

New treatments for dry eye target underlying problems.

A) Existing therapies and new approaches in the treatment of aqueous-deficient dry eye:

Artificial tears, which are lubricating eye drops, provide temporary relief by adding moisture.

Lifestyle changes like using a humidifier to increase the amount of moisture in the air around you, avoiding dry or highly polluted air environments, taking a break from your electronic devices, looking at far distance and blinking more often can also help.

Prescription anti-inflammatory eye drops such as cyclosporine (Restasis, Allergan and Cequa, Sun Ophthalmics) and lifitegrast (Xiidra, Novartis) can help reduce inflammation and promote tear production.

Varenicline solution(Tyrvaya, Oyster Point): A new nasal spray form of varenicline was approved by the U.S. Food and Drug Administration in 2021. The spray, a first of its kind treatment, stimulates tear, oil and mucin production. This nasal spray may be easier to apply than eye drops. Varenicline is actually a partial nicotinic receptor agonist and is a medication used in smoking cessation treatment.

In more severe cases, procedures like punctal plugs (to block tear drainage) might be considered.

B) Treatments for evaporative dry eye:

Current therapies so far have been limited to eyelid hygiene. A lid hygiene regimen includes 3 steps: eyelid warming, eyelid massaging and eyelid cleansing.

Lid hygiene is essential for good eye care since it plays a fundamental role in decreasing the viscosity of lipid layer and enhancing lipid secretion from meibomian glands, enabling the tear film to lubricate the ocular surface more efficiently.

Specialized new therapies include:

  1. Newer Medications: Perfluorohexyloctane (Evo tears) has been recently introduced in Europe as a product to treat Meibomian gland dysfunction and evaporative dry eye disease, based on its ability to stabilize tears and prevent evaporation. Since this non-aqueous, water-free and preservative-free liquid increased tear film breakdown time and lipid layer thickness, dry eye patients experienced a rapid reduction in dryness after using these drops.
  2. LipiFlow: This treatment uses heat and pressure to clear blocked oil glands in the eyelids, helping to improve tear quality.
  3. Intense pulsed light (IPL) therapy and thermal pulsation can help manage the condition as well.
  4. Nutritional supplements: Omega-3 fatty acids and flaxseed oil supplements are believed to help improve tear film stability and reduce dry eye symptoms.

It is important to consult an ophthalmologist for an accurate diagnosis and to determine the most appropriate treatment based on the specific underlying causes and severity of your dry eyes. Your ophthalmologist could recommend the most appropriate treatment based on your specific situation.

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