There are numerous other dry eye therapies that may improve your dry eye symptoms. The efficacy depends on the type and severity of dry eyes that you have, which will be determined at your dry eye evaluation appointment. One or more of the following may be recommended.
Blinking exercises When you are looking at a digital device for an extended period of time, you are likely not blinking well. Blinking is an essential part of maintaining the quality of tears on the surface of the eye - every time your top and bottom lids touch, it spreads the necessary tears and oils across the surface of your cornea. Studies have shown that on average, we blink 17 times per minute, but when looking at a screen, it reduces to 4 times per minute * Often when we believe we are blinking, we are doing incomplete blinks which mean the top and bottom lids do not fully touch which can lead to meibomian gland dysfunction. Your optometrist may recommend and demonstrate blinking exercises during your examination.
*Bentivoglio AR et al. Analysis of blink rate patterns in normal subjects. J Mov Disord. 2004;12(6):1028-1034.
Environmental changes Many people notice that their dry eye symptoms worsen in certain seasons and environments. For example, many patients report that their eyes feel worse in the winter when the heat is turned on indoors. The effects of this may be exacerbated if your eyelids naturally open slightly while sleeping. A simple way to improve this is to increase the humidity by adding a humidifier in your room. Ideal range of humidity should be 40-60%, as this can slow down the evaporation of your tears 1
* Wang MTM, Chan E, Ea L, et al. Randomized Trial of Desktop Humidifier for Dry Eye Relief in Computer Users. Optom Vis Sci. 2017;94(11):1052-1057. doi:10.1097/OPX.0000000000001136
Preservative-free artificial tears Instilling artificial tears is the quickest way to provide temporary relief from dry eye symptoms. However, not all drops are created equally. Different brands and products contain different ratios of moisturizing components. Some products contain preservatives and “anti-redness” chemicals which may result in reliance or toxic reactions if over-used. Your optometrist will be able to recommend which product is most suitable for your dry eye symptoms.
Warm compresses Meibomian gland dysfunction is the most common cause of dry eye symptoms. Warm compresses are a home therapy that is recommended for mild cases of meibomian gland dysfunction. Microwaveable eye masks containing beads that retain heat for at least 10 minutes are recommended to be used (warm towels do not provide sufficient constant heating). Consistent use of warm compresses are recommended for best results. If warm compresses are not providing sufficient relief from dry eye signs and symptoms, RF and IPL therapy may be recommended.
Supplements Omega-3 fatty acids are healthy fats that are absorbed from your diet. Given that omega-3 has an anti-inflammatory effect, it has been found to be beneficial for the maintenance of healthy meibomian glands. Omega-3 supplements that contain a higher amount of EPA and DHA will be more effective for your dry eyes. An adult daily dosage of 2000-3000mg of omega-3’s (with a 4:1 ratio of EPA to DHA) is generally recommended. Given the mixed results from current literature, supplements will likely be recommended as an adjunct therapy, and not as a stand-alone therapy.
Eye-lid wipes Anterior blepharitis (inflammation of the eyelid margin) is a very common eye condition leading to dry eye symptoms. It can be caused by overgrowth of bacteria or demodex mites. This condition may be exacerbated by eyelash extensions or with aging. To reduce the amount of overgrowth of bacteria or mites, lid wipes may be recommended. Specific product and frequency of usage will depend on your condition.
Anti-inflammatory drops Dry eye disease is inflammatory in nature. A short-term pulse dosage of a mild steroid may be prescribed to temporarily reduce the inflammation in episodes of moderate-severe dry eye. As steroids cannot be used long-term, other prescription eye drops may be prescribed, such as Retasis or Cequa. However, these drops require 2 drops a day for 3-6 months before any improvement in signs or symptoms are observed. The drops essentially re-train the immune system in the eyes to release less inflammatory markers into the tears, thus explaining the delay in its therapeutic benefits.
Oral antibiotics Your optometrist may prescribe a long-term dosage of an antibiotic that also has anti-inflammatory effects. This is only indicated in certain cases of dry eye disease (e.g. ocular rosacea or recurrent corneal erosions)
Book an appointment today to speak to your optometrist to see what treatment is most suitable for you!