Effective Treatments for Severe Dry Eye Syndrome: Exploring Options - Ophthalmology

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Severe dry eye syndrome can be a challenging condition to manage, especially when it is compounded by underlying health issues such as Sjögren's syndrome or the side effects of medications like antidepressants. Your mother's situation, characterized by persistent symptoms despite various treatments, indicates a need for a comprehensive approach to her care.


Understanding Dry Eye Syndrome
Dry eye syndrome occurs when the eyes do not produce enough tears or when the tears evaporate too quickly. This can lead to inflammation and damage to the eye's surface, resulting in discomfort, a sensation of dryness, and even visual disturbances. In your mother's case, the presence of filamentary keratitis (丝状结膜炎) suggests that her eyes are not only dry but also inflamed, which can exacerbate her symptoms.


Current Treatment Options
1. Artificial Tears and Ointments: These are the first line of treatment for dry eyes. It seems your mother has already tried various types, including preservative-free options, which are often recommended for chronic use.

2. Punctal Plugs: These are small devices inserted into the tear ducts to block drainage, thereby increasing tear film stability. While you mentioned that she has already undergone this procedure, it is worth noting that the effectiveness can vary from person to person.

3. Anti-inflammatory Medications: Prescription medications such as cyclosporine A (Restasis) or lifitegrast (Xiidra) can help reduce inflammation and increase tear production. If these have not been tried yet, they may be worth discussing with her ophthalmologist.

4. Autologous Serum Eye Drops: These drops are made from the patient's own blood serum and can provide a more natural tear substitute, especially for those with severe dry eye. If she has not yet tried this option, it might be beneficial.

5. Scleral Lenses: As you mentioned, scleral lenses can create a reservoir of fluid over the cornea, providing relief from dryness and protecting the eye surface. This could be a viable option if she is open to wearing contact lenses.

6. Environmental Modifications: Sometimes, simple changes in the environment can help alleviate symptoms. Using humidifiers, avoiding direct airflow from fans or air conditioning, and taking regular breaks from screens can make a significant difference.


Dietary Supplements
Regarding the suggestion to supplement with fish oil, there is some evidence to suggest that omega-3 fatty acids can help improve dry eye symptoms. Omega-3s are thought to reduce inflammation and may improve the quality of tears. However, the results can be variable, and it is essential to consult with a healthcare provider before starting any new supplement, especially considering her existing health conditions and medications.


Next Steps
Given that your mother has not seen significant improvement with her current treatment regimen, it may be beneficial to seek a second opinion from a specialist in dry eye disease or an ophthalmologist who focuses on ocular surface disease. They may offer additional insights or alternative therapies that could be more effective.

In summary, managing severe dry eye syndrome often requires a multifaceted approach tailored to the individual's specific needs and underlying conditions. Continuous communication with healthcare providers and exploring new treatment avenues can help improve her quality of life.