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Î Moisture inserts (hydroxypropyl cellulose) are occasionally helpful for
patients who are unable to use frequent artificial tears. (III, M, D)
Î Pilocarpine and cevimeline have been approved by the FDA to treat the
symptoms of dry mouth in patients with Sjögren syndrome. (I+, M, D)
Î Cyclosporine treatment has been shown to have short-term clinical
benefits in the treatment of dry eye. (I+, G, S)
Î Autologous serum drops have been reported to improve ocular irritation
symptoms as well as conjunctival and corneal dye staining in patients
with Sjögren syndrome. (III, In, D)
Î Autologous serum drops have been reported to improve ocular irritation
symptoms as well as conjunctival and corneal dye staining in patients
with graft-versus-host disease (GVHD). (III, In, D)
Î Filamentary keratitis can be treated with debridement of the filaments
or application of topical mucolytic agents, such as acetylcysteine 10%
four times a day. (III, In, D)
Î Filaments can be debrided with a cotton-tip applicator, a dry cellulose
sponge, or jewelers' forceps. (III, In, D)
Î If the patient has associated neurotrophic keratopathy, contact lenses
should be avoided. (III, G, S)
Î Permanent punctal occlusion can be accomplished by means of thermal
or laser cautery. (III, G, S)
Î If occlusion with cautery is planned, a trial occlusion with nonpermanent
implants generally should be performed first to screen for the potential
development of epiphora. (III, In, D)
Î A stepwise approach to cautery occlusion is generally recommended so
that no more than one punctum is cauterized in each eye at a treatment
session. (III, In, D)
Î A limited tarsorrhaphy can be performed to decrease tear evaporation
in patients with severe dry eye who have not responded to other
therapies. (III, In, D)
Î Rigid gas-permeable scleral lenses have been employed successfully
for years in the treatment of severe dry eye. (III, In, D)
