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Medical Channel Asia Latest Questions

Ashlxf

I have been having problems with dry eyes for the past 2 years. Tried all sorts if eyedrops and even gel at night but still not a 100% fix. It causes my eyes to sting and itch which is super uncomfortable. Any other more advanced treatment that could help?

I have been having problems with dry eyes for the past 2 years. Tried all sorts if eyedrops and even gel at night but still not a 100% fix. It causes my eyes to sting and itch which is super uncomfortable. Any other more advanced treatment that could help?

1 Doctor Answer

  1. Dr. Preethi Jeyabal, MBBS MRCS(Edin) FRCOphth(London)
    Director of Regenerative Aesthetics, Hair Restoration & Dry Eye Services at Eagle Aesthetics & Surgery.

    It sounds like you’ve been really persistent in trying to get relief, and that’s completely understandable — most treatments simply replace tears rather than tackle the root problem. When dry eye lingers for years, it’s important to dig deeper and understand why it’s happening.

    A thorough assessment can show whether it’s mainly a problem with tear quantity, tear quality, inflammation, or even eyelid gland function. Once we know that, we can choose more targeted treatments — such as prescription anti-inflammatory drops (like steroids and non-steoridal options like cyclosporine or lifitegrast), punctal plugs to help retain natural tears, or advanced heat-based eyelid therapies for meibomian gland dysfunction, including radiofrequency, intense pulsed light, thermal pulsation, thermo-mechanical action, etc. In some cases, autologous serum tears made from your own blood can help restore a healthier tear film.

    By addressing the underlying cause rather than just masking symptoms, we can aim for lasting relief — and hopefully reduce your reliance on constant eyedrops or other topical medications.

    Regards,
    Dr. Preethi Jeyabal
    MBBS MRCS(Edin), FRCOphth(London)
    Director of Regenerative Aesthetics, Hair Restoration & Dry Eye Services
    Eagle Aesthetics & Surgery
    IG: @drpreethisg_eyeskinhair

     

    The information provided on this forum is for educational purposes only and not intended as medical advice. Please consult a healthcare provider for any medical concerns, diagnosis or treatment.

1 Answer

  1. The following answer is provided by HELF AI (www.HELF.co), a next-gen AI backend built to power the health & wellness industry.

    Managing persistent dry eye disease (DED) can be challenging, especially when first-line treatments such as artificial tears and gels do not provide complete relief. Given your ongoing symptoms, it may be beneficial to consider more advanced treatment options. Here is a structured approach to managing your condition:

    1. Re-evaluation of Current Treatment:

    Frequency and Type of Artificial Tears: Ensure you are using preservative-free artificial tears, especially if you require frequent application (more than four to six times per day). Preservatives can exacerbate symptoms in some individuals.
    Gels and Ointments: Continue using gels or ointments at night, as they provide longer-lasting lubrication. Be aware that they can cause temporary blurring of vision.

    2. Advanced Topical Treatments:

    Topical Cyclosporine: This immunosuppressive agent can help reduce ocular surface inflammation. It may take several weeks to notice improvement, and it is particularly beneficial in patients with inflammatory components of DED.
    Topical Lifitegrast: An integrin antagonist that can reduce inflammation and improve symptoms. It is used twice daily and may provide relief for some patients.

    3. Procedural Interventions:

    Punctal Plugs: These are small devices inserted into the tear ducts to block drainage, thereby retaining moisture on the ocular surface.
    Autologous Serum Eye Drops: Made from your own blood serum, these drops can provide essential growth factors and nutrients to the ocular surface, promoting healing and reducing symptoms.

    4. Addressing Underlying Conditions:

    Meibomian Gland Dysfunction: If present, treatments such as warm compresses, eyelid massages, and oral tetracyclines (e.g., doxycycline) can be beneficial.
    Blepharitis Management: Regular eyelid hygiene with lid scrubs can help reduce inflammation and improve tear film stability.

    5. Environmental and Lifestyle Modifications:

    Humidifiers: Use in your home and workplace to maintain ambient humidity.
    Protective Eyewear: Consider moisture chamber glasses to reduce tear evaporation.
    Dietary Adjustments: Omega-3 fatty acid supplements may improve tear production and reduce inflammation.

    6. Systemic Treatments:

    Oral Omega-3 Fatty Acids: These supplements can help improve the quality of the tear film and reduce inflammation.
    Systemic Anti-Inflammatory Medications: In severe cases, systemic medications may be considered under the guidance of a healthcare provider.

    7. Consultation with an Ophthalmologist:

    – If your symptoms persist despite these interventions, a referral to an ophthalmologist is recommended. They can perform a comprehensive evaluation, including tests like tear break-up time, Schirmer test, and ocular surface staining, to tailor a more specific treatment plan.

    8. Consideration of Surgical Options:

    – In refractory cases, surgical interventions such as tarsorrhaphy (partially sewing the eyelids together) or salivary gland transposition may be considered.

    Conclusion:

    Persistent dry eye disease requires a multifaceted approach. It’s crucial to work closely with an eye care specialist to explore these advanced treatment options and tailor a plan specific to your needs. Regular follow-up is essential to monitor the effectiveness of the treatment and make necessary adjustments.

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