People with dry eye who have tried all the conventional treatments and modified their lifestyles and still aren't able to keep tolerably comfortable may be willing to explore these approaches including surgery and experimental drug treatments.
If needed, the ducts that drain tears into the nose can be permanently closed to allow more tears to remain around the eye. This is done with local anesthetic on an outpatient basis. There are no limitations in activity after having this surgery.
In some cases, depending on the cause, there may be reason to explore certain surgical approaches such as tarsorrhaphy (partial surgical closure of the eyelids to limit exposure) or other eyelid interventions.
Some optometrists are proponents of amniotic membrane transplantation (specifically in cases of conjunctivochalasis).
When conventional approaches have failed some alternatives for treatment include:
- Autologous serum eyedrops - These are eyedrops produced from one's blood. This is not a very common dry eye treatment but in clinical studies has shown promising benefits for some patients. Preparation methods vary, which will presumably also play a role in how well they work.
- DHEA drops - These address hormonal factors in dry eye
- Doxycycline eyedrops
- Drugs in clinical trials
Speak to your eye doctor to determine if any of these are appropriate for you.