Australian Dry Eye

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This is not a comprehensive list of treatments so please see the ‘Clinics’ page for a list of practitioners and the treatments they provide. Any of these should be able to provide advice on the treatments below and which may be suitable for your situation.

 

Note


  • Some of the treatments described require Therapeutic Goods Association (TGA) Special Access Scheme (SAS) approval to be accessed in Australia. Where this is the case your ophthalmologist or optometrist will have to arrange this for you.
  • There are compounding pharmacies who can prepare eye drops and other medications if they are not otherwise available. You will need to ask your doctor or call one of these compounding pharmacies to see what can be done. Not all compounding pharmacies can make up eye drops. If you are having trouble locating one, please email [email protected].
  • Preservative free drops. Whenever using a drop for dry eye, it is always preferable to use a preservative free drop if possible. In particular drops with the preservative Benzalkonium Chloride (BAK) should be avoided if they are to be used on a regular basis.
  • If you need further or more specific advice concerning treatments, please email [email protected]. Any information here is simply a result of our personal experience or research. We are not medical experts and advise you to seek further expert opinion about these treatments.
     

 

TREATMENTS

 


BlephEx

This in-office procedure is designed for the treatment of blepharitis. BlephEx™ reduces scurf and bacterial debris, the main causes of inflammatory lid disease, and improves the overall health of the eyelid. 


Blood derived drops

  • Autologous Serum Drops. Eye drops produced from your own blood plasma. The Red Cross in each State provides these free of charge but an Autologous Serum Request Form from an optometrist or ophthalmologist is required. 
  • Next+Bio a South African company produces Optiserum a drop made from umbilical cord blood serum in saline. This was briefly available in Australia in 2016 and maybe again soon.  (Currently, as at February 2017, there is a regulatory issue that is stopping the product from export from South Africa). As Optiserum is a blood derived product TGA  SAS approval is also required to import it into Australia. 
  • Regenerative Network International a US company produce Regener-Eyes a drop made from biomaterials emanating from human placentae.  TGA SAS approval would almost certainly be needed to import these into Australia.

 

Blephasteam
Produced by Thea Pharmaceuticals, this is an eyelid warming device claiming to relieve symptoms of meibomian gland dysfunction and associated diseases such as posterior blepharitis, meibomitis, ocular rosacea and chalazion.  Some optometrists offer Blephasteam as an in-office treatment however it is also possible to purchase the device for yourself and use it at home.

 

Cyclosporine A drops
This is generally known by the brand name Restasis however it is also possible to get this made as an eye drop by a compounding pharmacy. For the latter a prescription is needed while for the former a prescription as well as TGA SAS approval is needed. It is claimed that these drops can help to increase the natural tearing of the eye as well as reducing inflammation associated with chronic dry eye.

 

Compresses (warm and cold)

Warm and/or cold compresses applied externally on closed eyes on a regular basis provide relief and some longer term benefit for some patients. You should consult with your doctor for more about how to apply these.


Glasses with gaskets

Gasketted glasses are most often sunglasses that have a foam or rubber gasket inside the frame. The gasket should sit as close to the face as possible thereby minimising the moisture loss and also protecting the eyes from wind. For people with dry eye these are a great help especially when outside.

Some models offer clear as well as dark lenses and some can be fitted with prescription lenses. Different models are available (some from overseas). Two brands are Wiley-X and 7Eye and each of these have several models. If you need more information, especially concerning fitting prescription lenses, please email [email protected].

 

Intra-ductal Probing
Fine probe introduced into the meibomian gland to clear obstructions.

 

Intense Pulsed Light (IPL)
Claims to melt the solidified secretions of the meibomian glands over a number of treatments, varying with the severity of the condition, and reduce the severity of ocular rosacea symptoms. There are two brands of machine available in Australia.

 

Lifitegrast drops

These are sold under their brand name Xiidra. These are not yet available in Australia but it is possible to access these by obtaining a prescription from your doctor and by using an international pharmacy. Please email [email protected] for more details.

 

LipiFlow
This machine produced by US company TearScience claims to use heat applied to the inner eyelids and directed gentle massage to remove blockages from the meibomian glands. This treatment is designed to melt the solidified secretions of the meibomian glands. Several treatments may be required to achieve the desired effect.

 

Manuka Honey Drops
Many find these drops to be beneficial. They are produced from anti-bacterial Manuka honey by Melcare Australia. No prescription is required. Many pharmacies stock these.

 

Non-Steroidal Anti-Inflammatory drops (NSAID)

These drops can be used to treat inflammation associated with chronic dry eye. They will work ina similar way to steroid drops in that they will relieve some of the symptoms of chronic dry eye. However they are weaker than steroid drops but also have less adverse side effects. They should only be used under supervision of a doctor and a prescription will be needed. We believe that it is no longer possible to obtain a preservative free NSAID drop in Australia. However there is a drop, Acuvail, that is available in the US and can be brought into Australia with an Australia prescription via an international pharmacy. Please email [email protected] for more details.

 

Punctal Plugs and Cautery

Punctal plugs can be inserted into some or all of the puncta (the small holes through which tears drain away from the eye). This is done to slow down tear drainage and hence improve the lubrication of the eye surface in people who have aqueous deficient dry eye. There are temporary as well as permanent plugs that can be inserted. Speak with you eye doctor for more advice.

Another option is to get some or all of the puncta surgically closed - this is called punctal cautery. This will lead to a permanent closing so needs to be pursued only after careful consideration. An Oculoplastics Surgeon is the best specialist to consult about this.

 

Scleral Lenses

Scleral lenses (large contact lenses that sit on the sclera or white of the eye) are a very effective treatment to help people cope with the symptoms of severe dry eye. However, not all patients can tolerate the sensation of the edge of the lens on the sclera. Patience in getting used to the lens as well as many adjustments to the lenses may be needed. For this reason it is very important to find an experienced practitioner who is used to applying scleral lenses specifically for dry eye sufferers.

 

Steroid Drops

These are powerful anti-inflammatory drops and ointments which must be obtained by prescription from a knowledgeable practitioner. They can have long term side effects such as cataracts and glaucoma so should be used as sparingly as possible. Because of the risk of glaucoma it is important that you have your intra-ocular pressure (IOP) checked by an eye doctor regularly if using these. In Australia they include prednisolone, flurometholone, dexamethasone and hydrocortisone under many brand names.

 

Tetracyclines (e.g. Doxycycline and Minomycin)
These are sometimes prescribed for blepharitis or dry eye conditions associated with meibomian gland dysfunction. They may have various potential side effects including gastrointestinal reactions. A low dose course of several months is often prescribed.


Tranquileyes from Eye Eco

Tranquileyes are a pair of goggles specifically designed for dry eye. They do not allow any light through so are designed for sleep or times when you are not moving around. (Perfect for sitting on a plane.) The mask is held away from each eye by a thick foam gasket. They can be used on their own but also come with heat/cooling beads and moisture pads to offer the possibility of a hot or cold compress.

There a quite a few different models available.


Omega 3 Fatty Acids
It is believed Omega 3 may benefit the lacrimal system. Increased intake from food is ideal, such as oily fish but supplements are also available.