Uncommon Treatments for Dry Eye Syndrome

When it comes to treating dry eyes, most of us reach for an over-the-counter eye drop. But there may be a better approach to treating the common symptoms of dry eye syndrome.

Dry eyes, or dry eye syndrome (DES), are often part of a larger problem known as an ocular surface disease, or OSD. OSD represents dry eye syndrome and a host of other conditions that cause the exposed surface of the eye to become unhealthy. Dry eye syndrome and ocular surface disease can cause symptoms such as blurry vision, burning, redness, sandy, or gritty sensation in your eyes, irritation, and even pain. The severe dry eye can cause scarring and even a loss of vision. The primary, first-line treatment is usually OTC artificial tears, given several times per day. However, there are several lesser-known treatments that you may find very beneficial.

Lifestyle Changes

People with dry eyes often fail to understand how simply changing their lifestyle or habits can greatly improve dry eye symptoms. Simply stopping smoking or even reducing the places you go where more smokers may be present can have a dramatic effect on reducing dry eye symptoms. One underestimated change in lifestyle that can dramatically reduce symptoms is to get proper amounts of sleep, and to make sure you are adequately hydrated by drinking plenty of water every day. Coffee can dehydrate your body. Just cutting down to one cup of coffee in the morning instead of two may help a lot. Also, if you are reading a lot or using the computer more than a couple of hours at a time, take frequent breaks and actively think about blinking more often.

Acupuncture

Western medicine is slowly opening up to alternative medical treatments for certain conditions such as acupuncture. Some studies show that dry eye symptoms are improved with acupuncture, which seems to balance the autonomic nervous system that causes an anti-inflammatory effect by enhancing nerve activity.

Nutritional Supplements

Our eyes become drier as we age because of a decrease in the production of certain oils in the body. A lack of oils in the eye can lead to quick evaporation of tears. The meibomian glands in the eyelids help produce oil to prevent tear film evaporation. Omega-3 fatty acids improve the way these glands make and secrete the oil, which helps to stabilize tears. Omega-3 fatty acids, similar to those found in fish, have been shown to reduce the risk of developing dry eyes. Omega-3 fatty acids also play a role in reducing general inflammation by increasing the levels of anti-inflammatory mediators in the eye that reduce dry eye symptoms. Omega-3 fatty acids can be found in foods such as fish, walnuts, and wheat germ.

Biologic Therapeutics 

A biologic therapeutic is a therapy that is derived from a patient's own blood. Eye drops derived from whole blood are also known as autologous serum eye drops or platelet-rich plasma. To create autologous serum drops, blood is drawn from the patient and centrifuged (spun very fast) to allow for separation of the serum from the whole blood. This serum is then diluted with a liquid salt solution, such as saline. It is filtered and sterilized and placed into bottles for the patient to use up to eight times per day. One session typically takes about three months worth of treatment. The drops can be frozen until needed. This therapy is for unique cases, extreme DES, and DES that is secondary to an autoimmune disease. It can be expensive and requires monitoring.

Hormonal therapy

Hormones play a role in normal tear production, as evidenced by a significantly increased prevalence of OSD in perimenopausal and postmenopausal women. Estrogen seems to play a role in maintaining healthy tears. However, androgens (male hormones) are now getting more attention in the treatment of dry eye syndrome. DHEA, or dehydroepiandrosterone, is an important substance involved in the maintenance of secretory glands. In estrogen-deficient people, there is a deficiency of DHEA. Scientists feel that it may be helpful to supplement with oral DHEA to reduce dry eye symptoms. Recent studies show that oral supplements do not help much, but topically applied DHEA in eye-drop form may prove beneficial.

Anti-Inflammatories

Anti-inflammatory therapies are becoming more popular in the early treatment of OSD, as scientists are starting to better understand the role of inflammation in dry eye syndrome and OSD. Doctors usually recommend artificial tears in combination with a course of topical steroid eye drops, usually given multiple times per day in the first couple of weeks, and tapered down slowly to once or twice a day for several days. The course of steroids may last one to three months, after which some doctors then prescribe Restasis (cyclosporine A). Although many people may benefit greatly from this treatment, doctors are very cautious, as steroids can cause unwanted side effects, such as cataracts and glaucoma. Although the use of steroids is becoming more popular, it should be stated that the use of topical steroids for the treatment of dry eye is considered off-label by the FDA, meaning that it may be a doctor's decision to use a drug, but it may not be FDA-approved for that condition. Restasis, which is not a steroid—but an immuno-modulatory drug—is considered safer.

In July 2016 a drug called Xiidra became available. Xiidra was the first of its kind in a new class of medicine called lymphocyte function-associated antigen-1 (LFA-1) antagonist.