Dry eyes are typically only mildly irritating and do not cause prolonged damage to the eyes. However, in severe cases of dry eye, the pain can become much more intense and the damage to the eyes can become significant. The treatment for severe dry eyes is much more aggressive and involved than mild cases of dry eye.
To classify dry eye, there are stages or categories which are used to grade the overall impact of the dry eyes.
Mild dry eye is the most common and has occasional symptoms of dryness along with subtle signs which are visible on an eye exam by a doctor.
Moderate dry eye is more advanced; it will have symptoms that are frequent – usually daily. The signs that are associated with moderate dry eye are more pronounced and long-lasting.
Severe dry eye is the most advanced category of dry eye, and it has symptoms which are nearly constant and signs that are obvious. These cases are much different than mild and moderate dry eye as the pain and threat of visual impact is much greater.
The signs that are viewed in an eye exam can include defects on the front of the eye (corneal keratitis), abnormal staining with diagnostic dyes, changes to the oil glands, and the presence of filaments on the front surface of the eye.
Treating severe dry eye is usually a multi-faceted approach which has more than one treatment on going at a single time.
Treatments are aimed at protecting and repairing the surface of the eye, improving the quality of the tear film, and reducing future flare ups of dry eye symptoms.
To protect the front surface of the eye, there are treatments available including amniotic membranes and bandage contact lenses.
In severe dry eye, the majority of the damage to the eye is located on the front of the cornea.
Therefore, anything that will protect the cornea can be useful in treating dry eye. Both an amniotic membrane and bandage contact lens can be used for this purpose.
Commonly used in combination, these treatments provide a barrier to the front of the eye and prevent continued damage to the eye, allowing it to heal better.
To improve symptoms of dry eye, the tear film must be a more effective and nutritious membrane on the eye.
Treatments aimed at improving the tear film include expression of the oil glands in the eyelids, intense pulsed light treatment around the eyes, and using supplemental artificial tears.
These treatments provide a more natural and substantial tear film which protects and nourishes the front of the eye.
A major part of treating a case of severe dry eye is preventative treatment that reduces the risk of future cases of exacerbation.
A prescription for these medications is indicated if there is underlying inflammation as a cause of the dry eye.