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Are Prescription Eye Drops for Dry Eye Right for You?

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Dry eyes affect many people, especially in Alberta. A survey from 2019 by the Alberta Association of Optometrists revealed that as many as 90% of Albertans experience dry eye symptoms regularly, even if they aren’t aware of it. 

A visit to your optometrist for a regularly scheduled eye exam can provide a diagnosis for those experiencing symptoms. In some cases, a more extensive dry eye analysis may be recommended to determine the exact type of dry eye you may have. And if you have dry eyes, there are a number of dry eye treatments that can provide relief. You might be tempted to grab some over-the-counter eye drops and call it a day when you experience symptoms—but prescription eye drops might be a better fit for you.

What is Dry Eye?

Dry eye is an umbrella term for a handful of issues that can develop with your eye’s moisture levels. Your eye is a bit like an ecosystem, with parts that depend on other parts, and if there’s imbalance, dry eye and discomfort may be the result. Dry eyes can come in more than one subtype, severity, and symptoms can differ between patients.

Dry Eye & Your Cornea

Your cornea is a sensitive tissue most at risk when you develop a more severe case of dry eye. It’s the transparent dome-shape that protrudes from the whites of your eyes, and it covers your iris, pupils, and the parts of the eye behind it—all in careful alignment.

This tissue is a lot like skin, but it needs a lot of moisture to perform a focusing function for your eye. It also lacks blood vessels so it needs oxygen from water instead of blood to stay alive. If you ignore symptoms and dry eye spirals out of control, this could possibly affect your vision over time.

Tear Film

To draw oxygen from water instead of blood cells, your eye needs help. The tear film is a balanced multi-layer of fluids that allows even distribution of water across your corneas. It’s supposed to evaporate slowly and keep centered on your cornea while providing the water your corneas need.

At the base of the tear film is the mucous layer, which helps keep the tear film together and prevent water from pooling at the bottom eyelids, above produced by the conjunctiva and other specialized cells in the cornea. On top of the mucous layer are the watery tears from your lacrimal gland. On top of your natural level of tears, is the anti-evaporative oil layer, produced by the meibomian glands in your eyelids.

Different Types of Dry Eye

Dry eye comes in several different types because your tear film can be unbalanced in several different ways. But dry eye tends to fall into 2 major categories: aqueous tear-deficient dry eye, and evaporative dry eye.

Evaporative Dry Eye

Evaporative dry eye (EDE) means your tears evaporate near the same rate as water. Your oil layer ensures they don’t evaporate so quickly, but if your meibomian glands are blocked or under-producing, there won’t be enough oil to keep your tears at a normal level. Common symptoms include pain, redness and eye tearing.

Aqueous Tear-Deficient Dry Eye

If your actual tear volume is the issue, several sources might be to blame. Aqueous tear-deficient dry eye results from your lacrimal glands’ difficulty producing your base-level of tears—so there isn’t enough oxygen or moisture for the cornea. Tear-deficient dry eye can come from:

Like EDE, your eyes may show redness, itchiness, burning and blurry vision among other symptoms. But the key difference is in the volume of your tears. Your tear film might need something as simple as over-the-counter (OTC) artificial tears or they might require something more targeted like prescription eye drops.

Prescription Eye Drops Can Speed Your Relief

illustration of systematic prescription eye drop treatment from eye doctor.

In medical terms, prescription eye drops can help treat the root causes of your dry eye. The type of dry eye you have certainly affects your eye doctor’s choice of eye drops. It might be that your type of dry eye requires an agent to help the meibomian glands. Prescription eye drops for aqueous tear-deficient dry eye might include active ingredients that assist or supplement your lacrimal glands.

How Prescription & Non-Prescription Eye Drops Differ

Non-prescription eye drops are those you can buy over-the-counter (OTC). One of the most common types of OTC eye drops are artificial tears—a supplement to your basal (natural) tears. 

Artificial tears help patients with aqueous tear-deficient dry eye and can be a good fit for some to use as a home remedy. If dry eye symptoms continue with artificial tears it is best to consult your eye team to discuss other solutions such as prescription eye drops. 

Prescription Eye Drops vs. Visine

Compared to OTC eye drops, like Visine, prescription eye drops have quite a few advantages. Prescription eye drops:

  • Can be made without preservatives to reduce irritation
  • Help reduce inflammation, a key factor in dry eye
  • Treat the root causes of dry eye, rather than just the symptoms

Prescription Eye Drops for Dry Eye

While we might try OTC artificial tears out of the gate for your dry eye treatment, monitoring your eyes’ response to them is crucial. After some tests and assessments performed during your dry eye analysis, your optometrist might recommend prescription eye drops like Restasis or Xiidra. 

Xiidra

Xiidra is a prescription for combating inflammation. It soothes inflammation on key cells located on the cornea and conjunctiva, which helps the mucous layer of your tear film. That effect eases your dry eye symptoms, granting a more stable tear film. 

Restasis

Restasis was designed to help aqueous tear-deficient dry eye patients affected by inflammation in their lacrimal glands. The main draw of this prescription is that can actually help your lacrimal glands produce more tears if need be.

Your Optometrist Can Prescribe for You

Prescription eye drops can’t help everyone, but they provide tremendous relief for patients suffering from inflammation-related dry eyes. Diagnosis of the underlying cause of dry eye doesn’t come from your own research, however.

At Okotoks Eye Care, we use advanced diagnostics to determine whether dry eye treatment can leverage prescription eye drops like Restasis or Xiidra. Please ask for help!

Written by Dr. Asim Prasad

Dr. Asim Prasad is a native Calgarian who earned his Bachelor’s of Science degree in Vision Science and Doctor of Optometry degree from Nova Southeastern University in Ft. Lauderdale, Florida in 2008. Before becoming an optometrist, Dr. Prasad earned a bachelor’s degree in Environmental Science from the University of Alberta. After working in the environmental science industry for a short time, Dr. Prasad decided to pursue his true passion: optometry.
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