My Dry Eye Problem

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fkajoshaj

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To all practicing OD's,

I was wondering if I can receive any advice as to what steps I should take next in trying to find a solution to my dry eye condition that has been affecting my everyday life. My eyes are constantly burning, most times red and feel really dry. The optometrist I currently work for has done the schirmer's test only to confirm that I do have dry eye syndrome. If I remember correctly, I fell between the 7-9mm mark.

I have tried ALL of the following topical drops in hopes of finding a permanent solution:

-Vigamox (in case I had an infection)

-Zylet- this worked the best for me. However, the doc advised me to stop once I was done tapering the dosage. He told me that the steroid would inhibit my natural defense mechanism to fight off any antigen, and could also risk increasing my IOP.

-Zaditor (got the redness out, however, did not alleviate the dryness and burning sensation. My eyes are rarely itchy so I do not believe my dry eyes is caused by allergies)

-Lotemax
-Systane
-Gel Tears

None of which helped me find a permanent solution. I noticed that even when I try to focus, my eyes begin to tear and burn and turn red. It is really annoying me.

Does anyone doc out there, have any advice as to what I should do next?

P.S.
My doc advised me not to get punctal plugs
 
This probably isn't the place for medical advice, but in general what I tell patients to do about about dry eye is:
  • Avoid smoke, other irritants, angle AC vents away
  • Drink more water, dry eye is worse if you're dehydrated
  • Avoid caffiene, alchohol (also dehydrate)
  • uncorrected refractive error? CL wearer?
  • try to increase blink rate (esp at computer/reading)
  • Fish oil supplement (triglyceride prep over ester-based)
  • Artificial tears/ gel in pm (temp relief)
  • Punctal plugs (only in some cases)
  • Lotemax-may stimulate meib. glands
  • Restasis, $$ (works well, but takes 4-6 weeks to really kick in)
  • R/O sytemic causes (meds, Sjoogren's, rheumetiod
Sometimes the simpliest solutions are most effective, sometimes you have to get more complex
 
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