Dealing with Dry, Irritated Eyes? Here's What You Need to Know


Dry, burning, and irritated eyes can significantly impact your daily life. I'm Dr. Michael Chua from Pente Hills Eye Care, and in this comprehensive guide, I'll explore the top treatments for dry eyes. Stay with me until the end, where I'll highlight a commonly used remedy that can actually be harmful if used incorrectly.

Understanding the Basics of Dry Eye

Before diving into treatments, it's essential to understand the underlying causes of dry eyes. Our eyes are constantly coated by a thin film of tears that is not just water but a complex mixture of vitamins, minerals, and lipids. This tear film serves multiple purposes:

  • Lubrication: It keeps the surface of the eye smooth and clear.
  • Nutrition and Oxygen: It provides the cornea with essential nutrients and oxygen.
  • Protection: It washes away debris and protects against infections.

Every time we blink, we spread a fresh layer of this tear film across our eyes. However, when there is an imbalance in tear production or composition, dry eye symptoms can occur.

Meibomian Gland Dysfunction

A critical component of the tear film is the lipid layer produced by meibomian glands located in the eyelids. This lipid layer prevents the rapid evaporation of tears. When these glands become blocked, it can lead to a deficiency in the lipid layer, causing tears to evaporate quickly and leading to dry eye symptoms such as:

  • Redness
  • Irritation
  • Inflammation
  • Corneal damage

Autoimmune Diseases and Dry Eye

Certain autoimmune diseases, such as Sjögren's syndrome, lupus, and rheumatoid arthritis, can exacerbate dry eye symptoms by affecting tear production and the health of the tear film.

Top Treatments for Dry Eye

Now that we've covered the basics of dry eye, let's explore some of the most effective treatments available today.

1. Lubricating Eye Drops

When it comes to managing dry eye, not all eye drops are the same. With a wide variety of options available, choosing the right one can be overwhelming. Here are two top recommendations:

  • Systane Complete: This eye drop is a favorite because it contains a lipid component that mimics the natural oils in your tears. This makes it particularly effective at providing long-lasting relief by preventing evaporation and keeping the eyes hydrated.

  • Retaine MGD: Similar to Systane Complete, Retaine MGD also includes a lipid component, giving it a white, milky appearance. It is available in a preservative-free version, which is ideal for those who need to use drops frequently without the risk of irritation from preservatives. Both options are safe for contact lens wearers. Always shake the bottle before use to mix the lipid suspension.

2. Eye Ointments

For those experiencing severe symptoms, especially upon waking, eye ointments can provide extended relief. These ointments are thicker than drops and are best applied before bedtime due to potential blurriness. They work by creating a protective layer over the eye, offering continuous lubrication overnight. Effective brands include:

  • Genteal Gel
  • Refresh PM

3. Warm Compresses

Warm compresses are an excellent way to unclog the meibomian glands, allowing for the natural oils to flow freely into the tear film. When these glands are blocked, the oils can harden, similar to butter, instead of maintaining a fluid, olive oil-like consistency. Here's how to effectively use a warm compress:

  • Frequency: Apply the compress 2 to 4 times daily.
  • Duration: Each session should last about 15 minutes.
  • Method: You can use gel hot packs available at pharmacies. Heat them in the microwave for 20-30 seconds, ensure they're not too hot, and place them over closed eyes. Gently massage your eyelids to help express the oils.

4. Omega-3 Supplements

Dietary supplements rich in omega-3 fatty acids have been shown to support eye health and reduce dry eye symptoms. These fatty acids are found in fish such as salmon, sardines, and tuna. Research indicates that omega-3s can improve tear production and reduce inflammation. If fish isn't part of your diet, consider over-the-counter supplements from reputable brands like:

  • Nature’s Bounty
  • Nordic Naturals

5. Prescription Medications

For more persistent cases of dry eye, prescription medications may be necessary. Options include:

  • Xiidra: Works by reducing inflammation, improving tear quality, and enhancing comfort.
  • Restasis: Also reduces inflammation and helps increase tear production.

It's important to note that these medications require time to work, often taking 2 to 3 months before noticeable improvements are seen. They can also be expensive and may require insurance approval after demonstrating that over-the-counter treatments have been tried.

6. Punctal Plugs

Punctal plugs are a more advanced treatment option for severe dry eye. These tiny devices are inserted into the tear ducts to slow tear drainage, helping tears remain on the eye's surface longer. The procedure is quick, typically performed in-office, and provides immediate benefits.

A Word of Caution: Redness Relief Drops

Many patients turn to redness relief drops like Clear Eyes or Naphcon-A, which contain vasoconstrictors to temporarily reduce redness. However, these drops do not address the underlying dryness and can lead to a vicious cycle of dependency. Here's why they should be avoided:

  • Temporary Relief: They only mask redness without treating the root cause.
  • Rebound Redness: Prolonged use can cause the eyes to become even redder once the effects wear off.
  • Other Side Effects: These drops can dilate pupils, causing blurred vision and glare.

For these reasons, when patients come in using redness relief drops, I advise them to stop using them immediately.

Summary and Next Steps

Managing dry eye effectively requires the right combination of treatments tailored to your specific needs. Here's a quick recap:

  • First-Line Treatment: Start with lubricating drops like Systane Complete or Retaine MGD.
  • Overnight Relief: Use lubricating ointments such as Genteal Gel or Refresh PM for nighttime relief.
  • Supportive Treatments: Incorporate warm compresses and omega-3 supplements into your routine.

If symptoms persist, it's essential to consult with an eye doctor for a comprehensive evaluation and personalized treatment plan. This may include prescription medications or procedures like punctal plugs.

For those in the Los Angeles, Orange County, or Inland Empire areas, I invite you to visit our website or contact our office to schedule a consultation. I'm Dr. Michael Chua with Pente Hills Eye Care, and I'm committed to helping you find relief from dry eyes. 

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