Are your eyes dry?

An estimated 60 million Americans suffer

from this very common condition. Patients with dry eyes can experience burning, foreign body sensation, tearing, grittiness, redness and even eye pain.

As we get older, our eyelids produce less oil. Oil keeps our tears from evaporating off the eye and decreased oil production allows tears to evaporate too quickly, leaving the eye dry. Hot, dry, windy conditions, air-conditioning and smoke are common culprits, but prescription medications, including high blood pressure medications, anti-histamines, diuretics, anti-depressants ,anti-anxiety pills, sleeping pills, pain medications, hormone replacement therapy also cause dry eye symptoms. Even over the counter cold and allergy medications and sleep aids can cause dry eyes. Diseases such as Diabetes, Sjogren’s syndrome, Parkinson’s and Thyroid disease can also cause dry eyes.

Reading, watching the television or using a computer can aggravate dry eyes due to infrequent blinking associated with these activities. Contact lenses and eye surgery, including cataract surgery, refractive surgery and eyelid surgery can cause dry eye symptoms for several months.

The most common treatment for dry eyes is to use artificial tear drops which help make up for the lack of proper lubrication in our tear film. Artificial tears come in liquid form, longer lasting gel-form and long lasting ointment form (which is most often recommended for night time use).

Many different brands of artificial tears are available over the counter. Some contain preservatives and some do not. Unpreserved tears are recommended for people whose eyes are sensitive to the preservative and for more frequent use when preservatives can irritate the surface of the eye.

Another way to improve dry eye symptoms is to close off the drain holes in the inner corner of the upper and lower eyelids. Each drain hole is called a “punctum” and can be closed temporarily with tiny plastic plugs or permanently with an in-office procedure known as cauterization.

Dry eyes can be treated with prescription drops that improve tear production:

Restasis® (Allergan) was approved by the FDA over 20 years ago as a prescription medication for increasing tear production. This twice-a day drop has been shown to be very effective in improving dry eye symptoms and “curing” the dry eye condition in some patients.

Cequa® (Sun Pharma) and generic cyclosporine are now also available to patients. These anti-inflammatory drops can take 3 to 6 months to work and can cause burning or discomfort upon instillation.

Xiidra® ( Novartis) is another anti- inflammatory drop that uses Liftegrast as its active ingredient. It is available as a prescription twice daily treatment of dry eyes and can improve dry eye symptoms in several weeks. Some patients experience vision blurring, eye irritation and unusual taste sensation as a side effect.

Tyrvaya® (Oyster Point) was approved by the FDA in 2021. It is the first and only nasal spray for dry eye disease. This novel treatment stimulates branches of the trigeminal nerve inside the nose to help your eyes produce all the layers of the tear film with neurostimulation. Some find using a nasal spray easier than eye drops, although it can cause sneezing, coughing, throat or nose irritation as side effects.

Eysuvis® (Allergan) is the first ocular corticosteroid approved by the FDA for treatment of dry eye flare ups. It can only be used for 2 weeks at a time up to 4 times a day due to the side effects of chronic steroid use. Eysuvis works quickly and can be used in conjunction with other dry eye treatments.

Miebo® (Bausch and Lomb) was FDA approved in 2023. It is a first in class agent to coat the ocular surface and keep the tear film from evaporating.