Dry eye
Medical treatment
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| One of the many artificial tear preparations. Courtesy Alcon |
Simple strategies
There are some simple things you can do to help dry eyes.
- Avoid conditions that encourage evaporation of the tears such as air conditioning and hot dry heat from heaters and hairdryers.
- Wrap around sunglasses reduce wind movement across your eyes
Artificial tear supplements
Many people with dry eyes need to top up their natural tear production with artificial tears. You do not need a prescription to buy or use most artificial tears.
As you can see from the table below, there are many different types of artificial tears. Some artificial tears are very watery, others are very thick. Some drops have preservative, others do not. Some cannot be used by contact lens wearers. Everyone’s eyes are different and it may take a while to find the drop that is right for you.
Using artificial tear drops
The table below contains the name, lubricant and preservative of all the artificial tear drops currently available in New Zealand. The table is designed to help patients take control of their dry eye treatment by making therapy logical.
Start with a ‘thin’ drop. If it doesn’t seem to work, try using it more frequently or try another thin drop with a different preservative. Use the drops regularly. Dry eye treatment often fails because treatment is inadequate. If you don’t get relief, use a thicker drop.
If you develop an allergy (redness, itch etc) try a different preservative or a non-preserved drop. Use preservative-free drops if drops are required more than 6 times a day.
Ointments are usually too thick to use during the day. They are best used just before bed to give lasting relief overnight.
| Type | Name | Lubricant | Preservative |
| Thin drops | Cellufresh | Carmellose | None |
| Genteel | Hypromellose | Sodium perborate | |
| Liquifilm | Polyvinyl alcohol | Benzalkonium | |
| Methopt | Hypromellose | Benzalkonium | |
| Poly-Tears | Hypromellose/Dextran 70 | Polyquad | |
| Refresh | Polyvinyl alcohol/povidine | None | |
| Refresh Tears Plus | Carmellose | None | |
| Refresh Plus | Carmellose | None | |
| Systane | Polyethylene & propylene glycol/HP-Gar | Polyquad | |
| Tears Naturale | Hypromellose/Dextran | Benzalkonium | |
| Tears Plus | Polyvinyl alcohol/Povidine | Chlorbutol | |
| Thera Tears (bottle container) | Methylcellulose | Perborate | |
| Thera Tears (single use container) | Methylcellulose | None | |
| Thick drops | Celluvisc | Carmellose | None |
| Liquifilm Forte | Polyvinyl alcohol | Benzalkonium | |
| Methopt Forte | Hypromellose | Benzalkonium | |
| Thera Tears (single use container) | Methylcellulose | None | |
| Viscotears | Carbomer | Cetrimide | |
| Preservative free drops | Bion Tears | Hypromellose/Dextran | None |
| Celluvisc | Carmellose | None | |
| Poly Tears Free | Hypromellose/Dextran | None | |
| Refresh | Polyvinyl alcohol/Povidine | None | |
| Refresh Tears Plus | Carmellose | None | |
| Refresh Plus | Carmellose | None | |
| Thera Tears (single use container) | Methylcellulose | None | |
| Gels | Poly Gel | Carbomer/sorbitol | None |
| Ointments | LacriLube | Paraffin | None |
| Preservative free ointments | Polyvisc | Paraffin/wool fat | None |
Treatment for severe dry eye
Patients with severe dry eye may require more intensive therapy including:
- Steroid eye drops
- Serum tears
- Treatment of blepharitis
Steroid eye drops
Patients with severe dry eye always have some inflammation, both on the surface of the eye and often in the lacrimal gland itself. This inflammation can be part of a vicious cycle in which inflammatory changes and dryness each make the other worse.
Serum eye drops
Serum is the straw coloured liquid in our blood. It can be separated from whole blood and used as an artificial tear drop. Serum eyedrops are very expensive and can only be used if all other treatments fail.
Omega-3
Omega-3 supplementation is a recognised treatment for dry eye, reducing inflammation, increasing aqueous tear production and providing the meibomian glands with essential fatty acids with which to synthesise the oily gland secretions that reduce tear evaporation.
Our food contains two types of fatty acids known as Omega-3 and Omega-6. They are essential for our health and as our body cannot manufacture them, must be found in our diet.
Omega-3 is a 'good fat' which is used by the body to both produce anti-inflammatory compounds and block the activity of inflammatory mediators. Omega-6 is a 'bad fat' that promotes inflammation. It is not always possible to decrease dietary Omega-6 intake, but adding Omega-3 to your diet is a very effective way to reduce inflammation.
Beef, dairy products and the vegetable oils found in biscuits and snack foods are high in Omega-6. Because our diet is rich in animal and vegetable fats, many New Zealanders suffer from Omega-3 deficiency.
The best sources of Omega-3 are:
- Dark, oily, coldwater fish such as salmon and tuna
- Flaxseed oil, available from health food shops
- Capsules of fish and flaxseed oils, available from pharmacies