"This frustrating dry eye condition is just not linear... it does not get worse nor better on a straight path!"   There are so many variables such as tear chemistry, environment, treatments and unknown factors that chronic dry eye tends to be punctuated with acute bouts.   The management of these phases are very different.

Chronic Dry Eye is typically managed with some combination of:

1. Over the counter drops/gels/ointments (e.g. Hyabak, PUR, Thealoz DUO)
2. Omega 3 supplements
3. Procedure based treatments (e.g. IPL)
4. Warm compresses
5. Lid care
6. Prescription immune system modulating medications (e.g. Restasis)
7. Oral medications (e.g. doxycycline)
8. Low dose steroids (e.g. Alrex)

Acute Dry Eye is typically managed with all of the above plus

1. Topical steroids (e.g. Lotemax gel, FML)

Once acute treatments (steroids) kick in and eyes feel better, the question always arises "Why can't I stay on this medication!  It works so well".   Topical steroid treatment has risks and can actually make other eye conditions / infections worse.   Always follow your eye care providers recommendations and do not keep a bottle of acture treatment steroids for emergency use!

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Dr Morris