Fast Five Quiz: Are You Familiar With Dry Eye Disease?

Robert H. Graham, MD


September 29, 2017

Surgical options include the following:

  • Lateral tarsorrhaphy—temporary tarsorrhaphy (50%) is indicated in patients with dry eye disease secondary to exposure keratitis after facial nerve paralysis and after trigeminal nerve lesions that give rise to dry eye disease secondary to loss of corneal sensation

  • Conjunctivoplasty excision of symptomatic conjunctivochalasis

  • Surgical cautery occlusion of the lacrimal drainage system

  • Mucous membrane grafting

  • Salivary gland duct transposition

  • Amniotic membrane transplantation or amniotic membrane contact lens therapy

  • Prosthetic replacement of the ocular surface ecosystem (PROSE) lens therapy

Tear ointments can be used during the day, but they are generally reserved for bedtime use because of the poor vision after placement.

Punctal plugs are often used in the treatment of dry eye disease. Available types include the following:

  • Absorbable plugs—these plugs are made of collagen or polymers and either dissolve by themselves or may be removed by saline irrigation; occlusion duration ranges from 7 to 180 days

  • Nonabsorbable plugs—these plugs are made of silicone; two main categories of silicone plugs are available for dry eye: capped punctal plugs and intracanalicular plugs

  • Thermoplastic plugs (eg, SmartPLUG™; Medennium, Irvine, CA)—these plugs are made of a thermosensitive, hydrophobic acrylic polymer that changes from a rigid solid to a soft, cohesive gel when its temperature changes from room temperature to body temperature

  • Hydrogel plugs (eg, Oasis Form Fit™; Sigma Pharmaceuticals, Monticello, IA)

A study by Mataftsi and colleagues found that punctal plugs offer an effective and safe treatment for children with persistent symptoms and should be considered.

Specially made glasses known as moisture chamber spectacles, which wrap around the eyes to retain moisture and protect against irritants, may be helpful in some cases of dry eye disease.

Contact lenses may also be helpful; these are available in the following types:

  • Silicone rubber lenses

  • Rigid gas-permeable scleral lenses with or without fenestration

  • Highly oxygen-permeable lenses (overnight wear)

  • Cryopreserved sutureless amniotic membrane, which is available as a 5- to 10-day contact lens

For more on the treatment of dry eye disease, read here.


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