Treatment Dry Eyes

• Check all ingredients to make sure not allergic/sensitive to any of ingredients.
• If you are a soft contact lens wearer you cannot use preservatives containing benzalkonium at the same time.
• Unless stated otherwise (soft contact lens wearers can wear their lens 24 hours after their last drop of completed course (hard lens wearers straight after).
• All eye drops (not vials) should be discarded after 28 days of opening unless stated otherwise.
• All eyes products can cause blurred vision initially, should clear after blinking.
• Ointment/gel may take longer to clear (due to its viscosity, thicker formulation) and should ideally be used just before sleep.

Aim:

• Treatment for dry eyes is to help to maintain moisture/rehydrate the eye bringing it back to its normal function.

If one has dry eyes:

• A Low viscosity drops for day time (e.g. hypromellose 0.3%) can be used one drop as required.
• If one feels it not helping after a four weeks to six weeks trial then consider: Patients can then move up in viscosity to carmellose 0.5% and carbomer 0.2% for night-time treatment, with white soft paraffin or combinations with mineral oil in ointment form added to support hydration.
• Preservative-free formulations are preferred for frequent use.

Eye, allergy and inflammation. National Institute for Health and Care Excellence. Accessed February 2025. https://bnf.nice.org.uk/treatment-summaries/eye-allergy-and-inflammation/

Dry eye disease. BMJ Best Practice. September 2024. Accessed February 2025. https://bestpractice.bmj.com/topics/en-gb/962?q=Dry%20eye%20disease&c=suggested

• If still not helping then patient should consider talking to their optician, where an assessment can be made to check it is not due to meibomian gland dysfunction.
• Patients with elements of meibomian gland dysfunction may need to switch to sodium hyaluronate or a lipid-based preparation.

Dry eye disease. BMJ Best Practice. September 2024. Accessed February 2025. https://bestpractice.bmj.com/topics/en-gb/962?q=Dry%20eye%20disease&c=suggested

Dry eye disease . National Institute for Health and Care Excellence. 2023. Accessed February 2025. https://cks.nice.org.uk/topics/dry-eye-disease

• General tips

Dry eye drops

• These solutions/drops helps to retain moisture, they may cause initial blurring but not to the same extent as ointments i.e. hypromellose 0.3%, carmellose 0.5%.

Dry eyes ointments

• In general the more thicker (viscous) the product is (mainly ointment/gels) the more longer the product sticks to the eye and retains moisture, however it can cause initial blurring hence best used before bedtime i.e. carbomer 0.2%.
• The advantage is one uses it less regularly with the same effectiveness as the solutions/drops.

Meibomian gland disorder eye drops

• These drops help to provide an oily layer over the eye and help to prevent the tear from evaporating too quickly i.e. sodium hyaluronate or a lipid-based preparation.

Salt Water Sachets/drops (sodium chloride)

• Salt has natural antiseptic properties.
• Sachets are used to irrigate/wash the eye out and hence remove bacteria.
• Drops are ideal to carry and less messy and again are used to wash the eye out and fight the bacteria.

Wipes

• Wipes are available to clean the eye and moisturise the eye.

Eye Wash

• Help to flood the eye and remove bacteria. They also have antiseptic properties, from plant extracts.

Vitamins

• Zinc
• Flaxseed oil
• Spirulina
• Vitamin A
• Vitamin B1 (Thiamine)
• Vitamin B2 (Riboflavin)
• Vitamin B3
• Vitamin B6
• Vitamin B9 (Folic acid)
• Vitamin B12
• Vitamin C
• Vitamin E

Herbal

• Cysteine
• Grape seed
• Turmeric