Treatment for dry eye syndrome helps to control the symptoms, but there's no cure. Some people may have recurring episodes for the rest of their lives.
The exact treatment for dry eye syndrome depends on whether symptoms are caused by:
- decreased production of tears
- tears that evaporate too quickly
- an underlying condition
The first thing to consider is whether there are any obvious factors, such as a medication, causing the symptoms.
If your dry eye syndrome is caused by an underlying condition, your GP can prescribe treatment or refer you to an appropriate specialist.
You may also be able to help prevent dry eye syndrome or ease your symptoms by adjusting your environment, keeping your eyes clean, and improving your diet.
Read more about self-treating and preventing dry eye syndrome.
Mild to moderate cases of dry eye syndrome can usually be treated using lubricant eye treatments that consist of a range of drops, gels and ointments.
These lubricants are often called artificial tears because they replace the missing water in the tear film. However, they don't contain the antibodies, vitamins and nutrients found in normal tears that are essential for eye health.
Most lubricants are available without a prescription over the counter from a chemist.
There are many different types of eye drops and gels, and it's often worth trying a number of different ones to find one that suits you.
Sometimes you may have to use two or three different compounds to have the best effect. However, it's important you discuss any changes you wish to make to your treatment with your optometrist or doctor.
Some eye drops contain preservatives to prevent harmful bacteria growing inside the medicine bottle. If your symptoms mean you need to use these eye drops more than six times a day, it's better to use preservative-free eye drops.
This is particularly important if your ophthalmologist has told you that you have severe dry eye disease. Preservatives used in large quantities or over a prolonged period of time – months or years – may damage the delicate cells on the surface of the eye or cause inflammation.
If you wear soft contact lenses, you may also need to use a preservative-free lubricant, as preservatives attach to the contact lens and damage the eye. These types of eye drops may be more expensive.
If you have any difficulty putting in your drops, please discuss this with your doctor or optometrist. There are mechanical devices to help squeeze bottles, multi-dose bottles with valves, and single dose containers that may be easier for you.
'Oily' tear eye drops
Eye drops that replenish the oily part of the tear film and reduce evaporation from the surface of the eye are also increasingly being used. These preparations include synthetic guar gums or liposomal sprays.
Liposomal sprays are over-the-counter medications that aren't available on a prescription. They are sprayed on to the edges of your eyelids when your eyes are closed.
When you open your eyes, the solution spreads across the surface of the eye, creating a new oily film.
Oily tear drops are particularly useful if you have blepharitis or dry eye syndrome caused by your tears evaporating too quickly.
Eye ointments can also be used to help lubricate your eyes and keep them moist overnight, as your tears can evaporate while you sleep if your eyes aren't fully closed.
These ointments tend to be used overnight because they can cause blurred vision.
If you wear contact lenses, don't use eye ointments while wearing them. Ask your pharmacist or GP for advice about alternative treatments that may be suitable for you.
The underlying problem with long-term dry eye syndrome is inflammation in and around the eye. One of the anti-inflammatory treatments mentioned below may also be recommended, but these can only be obtained after you've seen an ophthalmologist.
Corticosteroid eye drops and ointments
Corticosteroids are powerful anti-inflammatory medications that can be given as eye drops or ointments in severe cases of dry eye syndrome.
They have side effects in around one in every three people, which may include:
- raising the pressure within the eye
This group of treatments should only be used if you're being reviewed by an ophthalmologist at an eye clinic. You shouldn't use these treatments if you have no follow-up at an eye clinic.
Low doses of medications called tetracyclines can be used as anti-inflammatory agents for a minimum of three to four months, and sometimes for much longer.
The most common tetracycline used is doxycycline, but others, such as oxytetracycline and lymecycline, are sometimes also prescribed.
Ciclosporin eye drops
Ciclosporin is a medication that suppresses the activity of your immune system. It is sometimes used in the treatment of severe dry eye syndrome that doesn't respond to lubricants.
This treatment is only available through a specialist in dry eye syndrome at a hospital eye department.
Serum eye drops
Serum eye drops may be required in very rare cases where all other medications haven't worked. These are special eye drops made using components of your own blood or blood from a donor.
The treatment is only available from the NHS Blood and Transplant Tissue Service through an ophthalmologist and after funding is approved.
To make serum eye drops, one unit of blood is taken under sterile conditions, as for regular blood donation. The blood cells are then removed and the remaining serum is diluted and put into eye drop bottles.
Because of quality standards, this process can take several months before the treatment is finally available to use.
Treating underlying medical conditions
If you have an underlying medical condition that's causing dry eye syndrome, your GP will prescribe treatment for it or refer you to an appropriate specialist.
If your dry eyes are severe and fail to respond to other forms of treatment, surgery may be an option. Two types of surgery sometimes used to treat dry eye syndrome are described below.
Punctal occlusion involves using small plugs called punctal plugs to seal your tear ducts. This means your tears won't drain into the tear ducts and your eyes should remain moist.
Temporary plugs made of silicone are normally used first to determine whether the procedure has a positive effect. If it does, more permanent plugs can replace the silicone ones.
In more severe cases, the tear ducts are sealed using heat (cauterised). This permanently seals the drainage hole to increase the amount of tears on the surface.
Salivary gland autotransplantation
Salivary gland autotransplantation is an uncommon procedure that's usually only recommended after all other treatment options have been tried.
This procedure involves removing some of the glands that produce saliva from your lower lip and placing them under the skin around your eyes. The saliva produced by the glands acts as a substitute for tears.