Treatment for Dry Eye (Level 2)
LEVEL 2
, Preservative Free Anymore than 4x a day use PF drops to avoid toxic reaction
If px complains of stinging on instillation switch to PF
Indicated if px had previous toxic reaction
Pharmaceuticals: Topical anti-inflammatory: short term use for severe inflammatory
- Topical anti-inflammatories: steroids and reaction e.g. intense conjunctival hyperaemia and extensive corneal
cyclosporin staining
- Tetracyclines - Only use in above or when level 1 management not worked
- Secretagogues
Steroids:
- Loteprednol
- Dexamethasone X
- Prednisolone X
- Fluoromethalone (FML)
However use a non-penetrating steroid for DED e.g. FML or lotemax
(IP ONLY)
FML q.i.d. for 1/52 then taper over next 3/52, same for lotemax
Topical steroids (such as fluorometholone or loteprednol) may be
considered for short-term use in some cases. The usual precautionary
surveillance is required
(GRADE*: Level of evidence=moderate, Strength of
recommendation=weak)
LEVEL 2
, Preservative Free Anymore than 4x a day use PF drops to avoid toxic reaction
If px complains of stinging on instillation switch to PF
Indicated if px had previous toxic reaction
Pharmaceuticals: Topical anti-inflammatory: short term use for severe inflammatory
- Topical anti-inflammatories: steroids and reaction e.g. intense conjunctival hyperaemia and extensive corneal
cyclosporin staining
- Tetracyclines - Only use in above or when level 1 management not worked
- Secretagogues
Steroids:
- Loteprednol
- Dexamethasone X
- Prednisolone X
- Fluoromethalone (FML)
However use a non-penetrating steroid for DED e.g. FML or lotemax
(IP ONLY)
FML q.i.d. for 1/52 then taper over next 3/52, same for lotemax
Topical steroids (such as fluorometholone or loteprednol) may be
considered for short-term use in some cases. The usual precautionary
surveillance is required
(GRADE*: Level of evidence=moderate, Strength of
recommendation=weak)
