Therapeutic Objective
Relieve symptoms by restoring normal tear secretion.
Therapy recommendations
- Use of tear substitutes (basic therapy).
- In meibomian gland dysfunction: tear substitutes containing lipids such as phospholipids, triglycerides and castor oil.
- In severe inflammatory reactions, topical anti-inflammatory therapy:
- Glucocorticoids: tapering off over a period of 2 to 4 weeks.
- Ciclosporin (cyclosporin A) (immunosuppressant): 0.05% eye drops* (2 x /d; also Tacrolism 0.05 eye drops (1-2 x /d) if necessary.
- Doxycycline (for meibomian gland dysfunction and rosacea): 40-400 mg/d or minocycline 50-100 mg/d; low dosage for 6-12 weeks is preferable.
- If necessary, complementary supplements / nutritional supplements (see below).
- Furthermore, the affected person should be advised to set up a humidifier at home.
- See also under “Further therapy” (eyelid edge care).
* Ciclosporin A achieves its effect by blocking T cells.For keratoconjunctivitis vernalis (VKC; eye disease with immunological-allergic component) ciclosporin A-containing eye drops are approved according to EMA. Conjunctivitis occurs bilaterally and recurrently-preferably in spring (“vernalis”).
Active ingredients (main indication)
- If cause-specific therapy cannot be performed, tear substitutes are prescribed; a distinction can be made among these:
- Eye drops
- Liposomal eye spray
- Eye gel
Active ingredients: drops against dry eyes contain the following ingredients, among others: carbomer, hyaluronic acid, polyvinyl alcohol, polyvidone, cellulose derivatives.Effects: Tear substitutes increase tear film stability, reduce surface stress and improve contrast sensitivity and optical quality of the corneal surface.Attention! Please make sure that the tear substitutes do not contain the epithelium toxic benzalkonium chloride as a preservative.
Supplements (dietary supplements; vital substances)
Suitable dietary supplements should contain the following vital substances:
- Vitamins (vitamin A (retinol), pyridoxine (vitamin B6), vitamin C (ascorbic acid), folic acid, vitamin E (tocopherols), cobalamin (vitamin B12) pyridoxine hydrochloride (vitamin B6), cyanocobalamin (vitamin B12).
- Minerals (magnesium)
- Trace elements (copper, selenium, zinc)
- Fatty acids (omega-3 fatty acids: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA); omega-6 fatty acid: gamma-linolenic acid (GLA)).
- Other vital substances (glutathione, L-cystine, L-tyrosine).