Table 2: Effective and low risk interventions for dry eye syndrome.

Approach

Details

Rationale

Treat underlying condition

Address local or systemic findings that may contribute to dry eye.

Treating the underlying cause will allow for improved tear secretion and ocular surface health

Lid hygiene

Patient is instructed to use a clean, warm and wet washcloth to gently scrub the upper and lower eye lid margin in the morning and evening.

Enhances secretion of tear glands in the eyelid

Warm compresses to the eyelids

Approximately three times a day patient to heat a wet washcloth to a temperature that can be safely tolerated on the skin, covers closed eyelids, and lets the washcloth cool to body temperature.

Enhances secretions of tear glands in the eyelid and also helps the flow of lipid based secretions as they are more liquid and less viscous when heated

Behavior modification

Don’t stare at computer screens, remember to blink often, look away from work or near activities periodically, don’t sit in areas with high airflow or drafts blowing across the eyes.

Decreases evaporation from the ocular surface

Add humidifier to room air

Forced air heat is very dry. Humidifying living or working areas can help reduce dry eye symptoms.

Decreases evaporation from the ocular surface

Use artificial tears

Start with pro re nata use of preserved solutions in multi-use containers. If symptoms require daily dosing, recommend preservative free formulations.

Wets the eye, protects the ocular surface, and helps arrest the vicious cycle of inflammation and corneal irritation

Night time use of gels or ointments

Gels or ointments are very effective at protecting the cornea in dry eye; they just cause visual blur. These products are well tolerated when used just before bed time.

Protects the ocular surface from desiccation during sleep

Increase systemic omega-3 fatty acid exposure

Source can be dietary or in the form of nutraceutical supplements, e.g. two 1000 mg capsules 3 times per day

Anti-inflammatory activity. Shown in some studies to improve dry eye symptoms and tear stability