Management Treatment - jpophthalibrary

Prevention tips: ^{[33, 37]}

Reduce exposure to airflow, low humidity, and prolonged screen use; this may improve adherence and expectations.

Follow the 20-20-20 rule, a simple yet effective way to reduce digital eyestrain caused by excessive screen time. By taking a 20-second break every 20 minutes to look at something 20 feet away, you can give your eyes a much-needed rest. ^[38]
Avoid direct airflow from sources like air dryers, car heaters, air conditioners, or fans into your eyes. Increase indoor air moisture, especially during winter, with a humidifier to combat dry indoor conditions. Consider wearing sunglasses or protective eyewear. ^[39]
It is used as a universal first-line treatment for all patients, especially those with mild intermittent symptoms and digital workers.

Stop or reduce medications that lower tear production or harm the surface of the eye, like topical preservatives and anticholinergics. “Ask your physician before any change in medication regimen.”
This is important for patients who may have dry eye disease caused by medications, such as antidepressants, isotretinoin, or long-term glaucoma treatments.

The heat from the warm compress helps to open the meibomian glands to improve oil gland function, increase oil flow into the eyes, stabilize the tear film, and slow down tear evaporation. ^[42]
Used for posterior blepharitis / MGD-predominant evaporative dry eye; first-line for lid disease.

To replace or enhance the tear film, select a formulation with the appropriate viscosity and lipid content based on the individual's needs, and avoid preservatives for patients requiring frequent use.
This treatment is suitable for those with mild to moderate dry eye disease (DED) who experience frequent symptoms.
For mild or transient cases of DED, recommended options include sodium hyaluronate, hydroxypropyl methylcellulose (HPMC), carboxymethylcellulose (CMC), and polyethylene glycol (PEG).
In more severe cases, a combination of agents may be beneficial, such as sodium hyaluronate combined with CMC. Additionally, ingredients like trehalose, betaine, glycine, allantoin, ectoine, phospholipids, and artificial tears can help support the ocular surface.

Explain the different types of artificial tears and which is best for your symptoms
Recommend a preservative-free or lipid-based brand suited for your needs
Advise how often to use drops safely
Suggest when to see your eye doctor if symptoms don’t improve

Adjunct to improve meibum composition; counsel on variability of evidence.
It is used for MGD patients or those seeking adjunctive therapy.
Foods rich in omega-3 fatty acids include fatty fish, such as salmon, sardines, and mackerel, as well as flaxseeds, chia seeds, and walnuts. They are best taken with meals, especially lunch.
Leafy Greens: Spinach, kale, and other leafy greens are rich in lutein and zeaxanthin, antioxidants that protect the eyes from damage and improve overall eye health.
Vitamin A is essential for maintaining a healthy tear film. Foods rich in vitamin A include carrots, sweet potatoes, and bell peppers. They are best taken with meals, especially lunch.
Citrus fruits, such as oranges and grapefruits, are rich in vitamin C, a powerful antioxidant that helps reduce inflammation in the eyes and supports healthy tear production. They are taken at any time, but preferably in the morning or midday.
Nuts and Seeds: Almonds, walnuts, and flaxseeds are rich in vitamin E and omega-3 fatty acids. These nutrients work together to protect the eyes from oxidative stress and support the production of tears. They are best taken with meals, especially lunch.
Avoid processed foods since they often contain high levels of unhealthy fats, sugar, and salt, which can contribute to inflammation and exacerbate dry eye symptoms. ^[46]

See an eye specialist if: ^{[40, 47, 53]}