Is there any medication that can be taken orally for dry-eye syndrome? Using artificial tears only gives me relief for a short time. I find that using an ointment is better, but the ointment blurs my vision.

Chris

There are currently no oral medications approved for the treatment of dry eye in the United States, and I am unaware of any clinical tests of oral drugs for dry eyes. That said, there are other treatment options that you may want to explore.

Dry eyes (keratitis sicca) is a very common problem and tends to occur in people as they age. Also, more women than men report problems with dry eyes. Symptoms of dry eyes include redness, discomfort, burning and the sensation of a foreign object in the eye. These symptoms may be exacerbated by heat or by air blowing from a fan or through the vents of a car. In addition, certain medications, such as antihistamines, can aggravate dry-eye condition.

It is crucial that a person with possible dry eyes have a complete eye exam, because there are many other conditions that can cause similar symptoms, including ocular allergies, recurrent epithelial erosion syndrome and possibly uveitis. Only after a diagnosis of dry eyes is made can the doctor consider possible treatment options.

As you mention, the primary treatment for dry eyes is the use of artificial tears (lubricating drops). There are numerous brands of artificial tears, and they fall into two categories: regular and preservative-free. Although preservative-free drops are more expensive, they are often worth the added cost. The preservatives in eyedrops can cause a toxic reaction when used more than four to six times a day. There are also a number of brands of lubricating ointments and gels that are designed to provide longer-lasting relief than eyedrops. These ointments and gels are effective in the treatment of dry eyes, but many brands cause blurring of vision such as you experienced. One newer brand, called Genteal gel, appears to provide long-lasting relief with minimal to no blurring of vision, and has therefore become a popular choice among people with dry eyes.

For severe dry eyes, lubrication may not be enough. The next step is for the eye doctor to insert punctal plugs. Punctal plugs are tiny plastic devices that fit snugly in the drainage ducts of the eyes. There are two drainage ducts in each eye (one in the upper lid and one in the lower lid). Blocking the lower two ducts with punctal plugs will dramatically decrease the drainage of tears from the eye. This results in the accumulation of tears in the eye and also keeps artificial tears in the eye longer. If a patient still has dry eyes after the lower ducts are plugged, doctors may block the upper ducts as well. It is only the rare patient with dry eyes who is not helped by a combination of punctal plugs and preservative-free drops.