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Most people with dry eye syndrome have no measurable abnormality of tear production, and no serious disease affecting tear composition.
Symptoms of dry eye may be caused by one or more factors such as:
Drugs which been reported to have adverse effects related to decreased tear production include:
Patients who present with dry eye should initially be provided with education and advice regarding non-invasive, self-help interventions (see below). Many of these products are cheap to buy and are readily available, along with advice, from pharmacies. Some self-care medicines are available in shops and supermarkets. Please click here for further information and a patient leaflet.
Clinicians should also consider medication which may be contributing to symptoms. Clinicians and patients should assess and evaluate the risk/benefit outcome and symptom severity before adjusting any treatment thought to be affecting dry eyes.
The severity of the condition and the person's preference should guide choice of pharmacotherapy for dry eyes.
Mild - moderate: Artificial tear substitutes
Severe: Non-preserved artificial tear substitutes
Simple, general advice to patients regarding the management of dry eyes should be offered to all patients to provide symptom relief. In mild cases of dry eye this may be sufficient and may avoid the need for pharmacological intervention.
Artificial tears required fewer than 6 times daily
Many products for mild-moderate symptoms can be purchased over the counter at a cost less than the prescription charge.
Products containing carbomers or polyvinyl alcohol require less frequent application due to their ability to cling to the eye surface but may be less well tolerated.
Eye ointments containing paraffin may be uncomfortable and blur vision; they are recommended for use at night and never with contact lenses. These products physically lubricate and protect the eye surface from epithelial erosion.
See section 11.8.1 Tear deficiency, ocular lubricants, and astringents
The products listed in this section are also suitable for patients with preservative allergy or intolerance, which should only be diagnosed by an ophthalmologist.
See section 11.8.1 Tear deficiency, ocular lubricants, and astringents