Good Hope Eye Clinic

Sore or dry eyes in brief

David Kinshuck Jan 2017

Introduction

word document


Tears are made in a gland near the top of the eyeball, and spread over the front of the eyeball into tear ducts, and then down into the nose. 'Dry eyes' occur when there are not enough tears to keep your eyes lubricated, or the tears that are produced do not spread evenly across the eyes.

tear flow from lacrimal gland

Tears are normally made in the lacrimal gland, and flow over the surface of the eye. They run down tiny tear ducts into the nose. See animation.

 

dry eyes, side view 
Side view

dry eyes, front view

Front view

Dry eyes or poorly spreading tears: the surface of the cornea is covered with dry patches (like craters on the moon), and this makes the eyes very sore

Treatment

  1. Healthy diet with plenty of fish and vegetables, no junk food.
  2. If you use the following drugs (or related drugs) ask your GP if the dose could be reduced: furosemide, bumetamide, omeprazole, lansoprazole, These drugs make the eyes dry/sore.
  3. Smoking makes the eyes much drier.
  4. Lid cleaning/hygiene may be needed…see Blepharitis page below
  5. Slightly dry: Xailin gel 4 times day and Xailin night at night
  6. More severely dry : Hylofort or Hyabak or Thealoz duo every ½-2 hours, and VitaPos at night
  7. This treatment takes about 4 weeks to work maximally
  8. See
    1. http://www.goodhopeeyeclinic.org.uk/sore%20dry%20eye.htm
    2. http://www.goodhopeeyeclinic.org.uk/blepharitis.htm
    3. http://www.goodhopeeyeclinic.org.uk/blepharitis.htm#lc     lid cleaning
  9. If this does not work consider
    1. If the eyes are red and inflamed, a short course of preservative free steroid drops such as dexamethasone preservative free twice daily for 3 weeks
    2. (if that works, consider replacing with cyclosporine [Ikervis twice daily] for more long term use)
    3. If still dry despite lots of lubricants, consider punctual plugs
  10. Glaucoma drops for severely dry eyes or eyes with drop toxicity need to be preservative free, eg
    1. Monoprost nocte
    2. Cosopt preservative free (trusopt and timolol) twice daily
    3. alternatively
    4. Dorzolamide  preservative free (trusopt) twice daily
    5. No timolol if asthma
  11. Score your dry eye..the Ocular Surface Disease Index here