In certain cases of dry eye, blepharitis and ocular surface disease we may need to add prescribed medical treatments to our in-practice treatments (IPL, BlephEx and punctual plugs) and at home treatments (heat, lid hygiene, artificial tears and ocular supplements) as part of your personalised treatment plan. As an ocular therapeutics practice we can provide you with a prescription for any required treatment.
Our treatment protocols are derived from the work of Tear Film and Ocular Surface Society (TFOS I and TFOS II) Dry Eye Workshop and Meibomian Gland Workshop, the landmark studies in the treatment of dry eye and blepharitis. We may choose to prescribe topical antibiotics (e.g. Azyter eye drops – azithromycin), oral antibiotics (e.g. Doxycycline or Azithromycin), topical steroids (e.g. FML Eye Drops – fluorometholone), topical anti-allergy eye drops (Opatanol Eye Drops – Olopatadine) as well as many other treatments depending on your diagnosis and severity.
On occasion we may involve your GP in the decision to prescribe medical interventions depending on your history, general health and other medications you currently take. In some cases we may refer you on to a consultant ophthalmologist colleague for consideration for cyclosporin treatment (ReStasis and Ikervis) if we deem it relevant. Ciclosporin is a medication that suppresses the activity of your immune system and is sometimes used in the treatment of dry eye syndrome.
Other medical treatments
Autologous serum eye drops
In very rare cases, where all other medications have not worked, autologous serum eye drops may be required. Special eye drops are made using components of your own blood. It is only available from the National Blood Service through an ophthalmologist and after funding is approved.
To make autologous serum eye drops, one unit of blood is taken under sterile conditions (as for regular blood donation). The blood cells are then removed and the remaining serum is put into eye drop bottles. Because of quality standards, this process can take several months before the treatment is finally available to use.
If your dry eyes are severe and fail to respond to other forms of treatment, surgery may be an option. Two types of surgery sometimes used to treat dry eye syndrome are described below.
Salivary gland autotransplantation
Salivary gland autotransplantation is an uncommon procedure that is usually only recommended after all other treatment options have been tried. This procedure involves removing some of the glands that produce saliva from your lower lip and placing them under the skin around your eyes. The saliva produced by the glands acts as a substitute for tears.