Dry Eye Treatment

Chronic dry eyes can make you miserable. They are annoying, painful, and can be an early indicator of a serious health problem. There are many causes of dry eyes including:

• Poor tear production. Either quantity or quality
• Poor blinking.
• Wearing contact lenses.
• Environmental effects. Computer screens, air conditioning, pollen
• Medications.
• Diseases.

Our experts at Union Square Eye Care offer 4 treatments for dry eye relief that we can help you with at both of our locations.

Topical Lubricant Eye Drops and Ointments

Most chronic dry eye sufferers find relief from over-the-counter eye drops. There are numerous options available. The “Artificial Tears” help replace the tears in your eyes. Some have thickening agents which help keep the drops on your cornea longer. Others have ingredients that help heal the inflammation on the surface of your eyes. Each brand has some differences so try several to see if you can find the one that works for you. There are also ointments that you can use, applied along the inside of your lower lid. The ointment will blur your vision, so most people use the ointment right before going to bed. With the drops and ointment, the one detail you need to be aware of is preservatives.

• Eye Drops with Preservatives. These drops come in larger size bottles. They include chemicals that prevent bacteria from growing if the bottle comes in contact with the eye.
• Eye Drops without Preservatives. Come in single-dose disposable vials.If you have a sensitivity to preservatives or have allergies this is usually the best option for you.

Prescription Medication

If you have tried several of the over-the-counter eye drops and ointments without relief, tell your Ophthalmologist or Optometrist. The next step may be to try the prescription medications. There are currently two options, Restasis and Xiidra. These two are both eye drops that provide relief for Dry Ey Syndrome, but there are some differences.

Restasis

Restasis was the first FDA-approved prescription eye emulsion in 1983. The term emulsion means that it includes oil to help the drop stay on the cornea longer. Restasis is believed to work by decreasing the inflammation of your eye and increasing your natural tear production. Cyclosporine is used in the treatment of conjunctivitis, and other allergic eye conditions, so this may be why it helps with Dry Eye Syndrome. Studies indicate that it may take as long as 6 months of continual use to get significant relief. There is no generic substitute.

Xiidra

Xiidra has been FDA-approved for the treatment of dry eyes since 2016. This drop is a new class of medications called lymphocyte function-associated antigen 1 antagonists. Research finds that it works by blocking LFA-1 on T cells from binding with ICAM-1. Xiidra is a non-steroidal, preservative-free drop, so it comes in single-use vials. Patients have reported significant improvement in as little as 2 weeks. Xiidra users have reported side effects of headaches and unusual taste changes which were not noted with Restasis. Xiidra is more expensive than Restasis and may be non-covered by your insurance. Be sure you check with your carrier prior to discussing this medication with your eye doctor. The retail cost for a 90-day supply may be as expensive as $600-$700.

Punctal Plugs

Punctal Plugs are frequently a good option for people with dry eyes due to a lack of tear production. There is sometimes confusion about how plugs are going to help with increasing tears. People seem to believe that the tears are released from the top ducts and then run out of the bottom ducts. Tears come out of the lacrimal glands that are way up under your upper lids. The tears then flow down over your eye and drain out of the tear ducts.

Punctal plugs are tiny biocompatible devices that your eye doctor inserts in the tear ducts to stop the drainage. This keeps the tears on your eyes longer. You may need just the lower plugs or both upper and lower. Temporary plugs may be inserted first to see if this is a good solution for you. Temporary plugs are usually made of collagen which will dissolve within a few months. At that time your doctor will discuss a long-term solution with you. The semi-permanent plugs are silicone or acrylic and expected to stay in your ducts for many years. There are few side effects or problems from these plugs, but they can be removed easily. Depending on the location in the puncta, the plug can either be pulled back out or flushed out with saline.

Amniotic Membranes

Amniotic Membrane is used in the eye as a type of temporary graft to heal the cornea after long-term Dry Eye Syndrome. This is only when attempting the previous remedies and finding them ineffective. An amniotic membrane will promote epithelial healing of a damaged cornea. The membrane has anti-inflammatory, anti-microbial, and anti-scarring properties. It encourages natural growth to heal the ocular surface. The experts at Union Square Eye Care are using Surgenex as the provider for the amniotic membranes. They developed the SurSight membrane exclusively for ocular purposes. Our doctors selected this product for these reasons:

• Donor Screening
• Only C-section births to guarantee quality and safety
• Rapid Delivery to lab
• Processing exceeding FDA requirements
• Sterilization by irradiation
• Stored at ambient temperatures
• Priority shipping
• Records portal for patient results tracking

The physician places the amniotic membrane onto the damaged cornea. It is similar to a thick contact lens. It may be slightly uncomfortable and blur your vision. Usually, the membrane is only left on for 1-2 weeks, depending on your corneal healing. Healing your ocular surface should resolve most of your dry eye issues. This process is covered by Medicare and most other insurance carriers.

If you think you have Dry Eye Syndrome or already have that diagnosis, contact us. Our experts at Union Square Eye Care will help diagnose the level of dry eye you have, and the appropriate care you need. We will find you relief.