Dry eye syndrome can span a spectrum from mild to moderate and severe. Treatment protocols also may vary from clinic to clinic, but it is worth mentioning the goals of treatment and the general principles that can be used to alleviate the problem.
Among the problems associated with dry eyes is the development of punctate corneal epithelial erosions (little dry spots on the cornea). If a large number of these appear and if they develop in the centre of the cornea, vision will become blurred. In the worst cases, some amount of scarring can also develop. Treatment aims to minimize or eliminate these erosions, as well as to minimize eye irritation and feelings of eye dryness/discomfort.
Treatment for dry eyes with any protocol always starts with frequent artificial tear use, and in the case of moderate to severe dry eye conditions, preservative free preparations are used. If significant inflammation is noted, topical steroids or cyclosporine can be added as well. This is done in conjunction with general measures such as stopping contact lens wear and frequent breaks from computer use, as well as treatment of any contributing eyelid condition such as blepharitis.
If a dry eye state persists and requires very frequent eyedrop use, but where the inflammation is under control or is not a significant factor, then punctal plugs are very useful.
These methods are used to achieve a state where there are minimal punctate erosions, and where there are minimal symptoms, before a patient would be considered for surgery.
If a patient has severe dry eyes that require more intensive treatment than this, or where it is associated with an underlying systemic disease, most doctors would advise against laser refractive surgery.
