There are methods to partially or completely close the tear ducts. This blocks the flow of tears into the nose, and thus more tears are available to the eyes. Drainage into either one or both puncta in each eye can be blocked. Punctal plugs are inserted into the puncta to block tear drainage. It is not clear if punctal plugs are effective at reducing dry eye syndrome symptoms. Punctal plugs are thought to be "relatively safe", however, their use may result in epiphora (watery eyes), and more rarely, serious infection and swelling of the tear sac where the tears drain. They are reserved for people with moderate or severe dry eye when other medical treatment has not been adequate.If punctal plugs are effective, thermal or electric cauterization of puncti can be performed. In thermal cauterization, a local anesthetic is used, and then a hot wire is applied. This shrinks the drainage area tissues and causes scarring, which closes the tear duct. Other
Heating systems that try to unblock the oil glands in the eye has some preliminary evidence of benefit. Fish oil (omega-3) supplements are not effective in relieving symptoms. Surgery
In severe cases of dry eyes, tarsorrhaphy may be performed where the eyelids are partially sewn together. This reduces the palpebral fissure (eyelid separation), ideally leading to a reduction in tear evaporation. Prognosis
Keratoconjunctivitis sicca usually is a chronic problem. Its prognosis shows considerable variance, depending upon the severity of the condition. Most people have mild-to-moderate cases, and can be treated symptomatically with lubricants.
Symptoms reduce during cool, rainy, or foggy weather and in humid places, such as in the shower.Most people who have dry eyes experience mild irritation with no long-term effects. However, if the condition is left untreated or becomes severe, it can produce complications that can cause eye damage, resulting in impaired vision or (rarely) in the loss of vision.Symptom assessment is a key component of dry eye diagnosis – to the extent that many believe dry eye syndrome to be a symptom-based disease. Several questionnaires have been developed to determine a score that would allow for a diagnosis. The McMonnies & Ho dry eye questionnaire is often used in clinical studies of dry eyes. Causes
Any abnormality of any one of the three layers of tears produces an unstable tear film, resulting in symptoms of dry eyes. Increased evaporation
The most common cause of dry eye is increased evaporation of the tear film, typically as a result of Meibomian gland dysfunction. The meibomian glands are two sets of oil glands that line the upper and lower eyelids and secrete the oily outer layer of the tear film—the lipid layer. These glands often become clogged due to inflammation caused by blepharitis and/or rosacea, preventing an even distribution of oil. The result is an unstable lipid layer that leads to increased evaporation of the tear film.In severe cases of MGD, the meibomiam glands can atrophy and cease producing oil entirely. Low humidity
Low humidity may cause dry eye syndrome.