How to self-manage Keratoconjunctivitis Sicca (Dry Eye Syndrome)?

From the Guidelines

To self-manage dry eye syndrome, start with artificial tears used 4-6 times daily, choosing preservative-free options like Systane Ultra or Refresh Optive if using frequently, as recommended by the most recent study 1. This approach is based on the latest evidence from the 2024 study published in Ophthalmology, which emphasizes the importance of addressing potentially exacerbating exogenous factors such as antihistamine or diuretic use, cigarette smoking, and exposure to second-hand smoke, as well as environmental factors like air drafts and low-humidity environments 1. Key steps to self-manage dry eye syndrome include:

• Staying hydrated by drinking 8-10 glasses of water daily and using a humidifier in the home, especially in dry environments or during winter
• Taking regular breaks from screens following the 20-20-20 rule (look 20 feet away for 20 seconds every 20 minutes)
• Applying warm compresses to the closed eyelids for 5-10 minutes daily to help unclog oil glands, followed by gentle eyelid massage
• Considering omega-3 supplements (1000-2000mg daily) which can improve tear quality
• Avoiding smoke, direct air from fans or heaters, and wearing wraparound sunglasses outdoors
• If wearing contact lenses, reducing wearing time or switching to daily disposables
• For moderate to severe symptoms, using over-the-counter options like Restasis or Xiidra to help increase tear production, as supported by the 2024 study 1. It is essential to consult an eye care professional if symptoms persist despite these measures, as prescription treatments may be necessary, especially for patients with underlying conditions like Sjögren's syndrome, which can increase the risk of lymphoproliferative disorders 1.

From the FDA Drug Label

INDICATIONS AND USAGE RESTASIS® ophthalmic emulsion is indicated to increase tear production in patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca. CLINICAL PHARMACOLOGY Mechanism of Action Cyclosporine is an immunosuppressive agent when administered systemically. In patients whose tear production is presumed to be suppressed due to ocular inflammation associated with keratoconjunctivitis sicca, cyclosporine emulsion is thought to act as a partial immunomodulator.

The FDA drug label does not answer the question of how to self-manage dry eye syndrome, as it only discusses the mechanism of action and indications for the use of cyclosporine ophthalmic emulsion in increasing tear production in patients with keratoconjunctivitis sicca 2 2.

From the Research

Self-Management of Dry Eye Syndrome

To self-manage dry eye syndrome, several strategies can be employed, including:

• Dietary changes: Consuming foods rich in omega-3 fatty acids, such as fish and flaxseeds, may help alleviate dry eye symptoms 3, 4, 5, 6, 7
• Nutritional supplements: Taking omega-3 fatty acid supplements, particularly those containing eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may help reduce dry eye symptoms and improve tear quality 4, 5, 6, 7
• Lifestyle modifications: Avoiding dry environments, taking regular breaks when working on computers, and using humidifiers may help reduce dry eye symptoms

Omega-3 Fatty Acid Supplementation

Omega-3 fatty acid supplementation has been shown to be effective in managing dry eye syndrome, with benefits including:

• Improved tear break-up time (TBUT) 4, 7
• Increased Schirmer test values 4, 6, 7
• Reduced tear osmolarity 5, 6
• Improved dry eye symptoms 4, 5, 6, 7

Important Considerations

When considering omega-3 fatty acid supplementation for dry eye syndrome, it is essential to:

• Consult with a healthcare professional to determine the best course of treatment 3, 5
• Choose a high-quality supplement that contains EPA and DHA 6
• Monitor progress and adjust treatment as needed 5, 6