I am using eyedrops constantly, yet my eyes still hurt all the time. Why? (Posted: 3 dec 2004)

Artificial tears are not a cure-all for dry eye. "Dry eye” itself is simply a broad category of conditions. One of those conditions is what’s called an aqueous tear deficiency – that is, failure of the lacrimal glands to produce sufficient tears. If you have an aqueous deficiency, it is likely that use of artificial tears and/or punctal plugs may be of benefit to you. However, if your primary problem is tear film imbalance - for example, insufficient production of the lipid layer of the tears which prevents them from evaporating too quickly - artificial tears may not help. In fact, overuse of artificial tears may make things worse by diluting your tears and causing a worse imbalance. (Some patients who chronically overuse artificial tears find that their symptoms actually improve when they cut back or stop using them.) If you are frequently using artificial tears but show no improvement or your condition worsens, speak with your eye doctor about pursuing a different course of treatment.

When I put eyedrops in, my vision clears, but only for five or ten minutes. Why? Does this mean that my eyes are extremely dry? (posted: 3 dec 2004)

If clearer vision after insertion of artificial tears is quite transient, then other than extreme cases it is unlikely the cause of the vision problems is simply dry eye (though that may be a component). There are two ways in which artificial tears can make your vision temporarily clearer. First, the liquid acts as a refractive medium. That is, it can be like placing a slight glasses prescription over your eye, and this causes your vision to sharpen up a bit. Second, the liquid on the surface of your eye temporarily smooths irregularities. If your corneal surface is not smooth, it can fill in the valleys and create an artificially smooth surface - until the drops drain from your eyes. (Gas permeable lenses can correct the effect of corneal irregularities in much the same way, except obviously than you can control the duration.)

Why should I use non-preserved artificial tears? They are awfully expensive. (posted: 3 dec 2004)

Not all preservatives are equal! Certain preservatives dissipate on insertion into the eye, or simply do not act as irritants. But the common preservative benzalkonium chloride, which is used to preserve most (not all) artificial tears that come in a bottle, is known to cause buildup and irritation if used regularly. Since most products currently available over the counter come in only two forms - preserved with benzalkonium chloride, or non-preserved unit doses, the latter are preferable when you are planning to use them regularly or frequently.

How long should I use an artificial tear before I give up? (posted: 3 dec 2004)

It depends on the effect you are experiencing. You should be prepared to give an eyedrop a fair trial - that is, it's not reasonable to discard it if it doesn't produce miracles in the first 24 hours, unless it is producing unwanted side effects or irritation. We suggest a minimum of a week. However, you should discuss this with your doctor and act on his/her advice.

I have been taking flaxseed oil for three months now. I really can’t tell whether it’s helping. Should I continue? (posted: 3 dec 2004)

There is a lot of trial and error involved in trying to find the right treatment or combination of treatments to manage symptoms of dry eye syndrome. Many patients do several treatments simultaneously - for example, artificial tears, lid therapy, supplements and sometimes medications - and it can be difficult to tell what is or isn't helping. Sometimes you only find out by stopping a treatment and seeing whether you are unchanged or have an incremental change for the better or worse. However, with flaxseed oil in particular, it is an essential oil and good for your general health, and it can take quite some time for the benefit to the meibomian glands to be apparent, so an appropriate dose is a good thing for the long term.

How can I get punctal plugs? (UK patients) (posted: 3 dec 2004)

Ask your GP to refer you to an optometrist ophthalmologist who can fit plugs. Punctal plugs are quite expensive if done privately, therefore it is to your advantage to get them through an NHS doctor if possible.

These eyedrops are really adding up. Are dry eye treatments ever covered by insurance? (US patients) (posted: 3 dec 2004)

Many dry eye treatments can be very expensive over time. Call your insurer to find details of their coverage and what the requirements are. If you have serious or persistent dry eye symptoms, speak with your GP and/or regular eye doctor about getting a diagnosis which will help you submit a claim with your insurer. The technical term for dry eye syndrome is keratoconjunctivitis sicca.

I don’t understand a lot of the terminology used here. How can I learn more? (posted: 3 dec 2004)

Look up unfamiliar terms in the Encyclopedia. Except for certainly highly technical terms, almost everything has a simple patient-friendly explanation in the “In Brief” section. If you’re still puzzled, visit our community forums, D’Eyealogues, and post a question. Don't be shy - we are here to help, not confuse you.