Nonpharmacologic Therapy

Behavioral and environmental modifications may significantly improve dry eye, especially in mild cases. Evaluate the patient's environment for air drafts. Consider adding a humidifier in low-humidity areas. Schedule regular breaks from computer work or reading. Lower the computer screen to below eye level to decrease lid aperture. Evaluate medication profile and therapeutically substitute medications that do not exacer-

bate dry eye. Spectacle sideshields or goggles may reduce tear evaporation.

If pharmacologic and other therapies are not sufficient, punctal occlusion or lateral tarsorrhaphy may be an option. Punctal occlusion is the plugging of the punctal drainage sites with collagen (temporary) or Silastic (permanent) plugs. Lateral tarsor-rhaphy sutures portions of the lid margins together to decrease evaporative tear loss. These procedures are reserved for severe cases of dry eye secondary to other diseases.1

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