12
Management
Counseling and Referral
Î The most important aspects of caring for patients with dry eye are to
educate them about the chronic nature of the disease process and to
provide specific instructions for therapeutic regimens. (III, G, S)
Î It is helpful to periodically reassess the patient's compliance and
understanding of the disease, the risks for associated structural
changes, and to re-inform the patient as necessary. (III, G, S)
Î Patients with pre-existing dry eye should be cautioned that
keratorefractive surgery, particularly LASIK, may worsen their dry
eye condition. (III, G, S)
Î Patients who have dry eye and are considering keratorefractive
surgery should have the dry eye treated before surgery. (III, G, S)
Î In moderate to severe cases that are unresponsive to treatment
or when systemic disease is suspected, timely referral to an
ophthalmologist who is knowledgeable and experienced in the
management of these entities is recommended. (III, G, S)
Î Referral to an internist or rheumatologist can be considered for
patients with systemic immune dysfunction or for those who require
immunosuppressive therapy. (III, G, S)
Î Patients with systemic disease such as primary Sjögren syndrome,
secondary Sjögren, or connective tissue disease such as rheumatoid
arthritis should be managed by an appropriate medical specialist.
(III, G, S)
