What are the recommended first-line treatments for patients diagnosed with dry eye syndrome in primary care?

For patients diagnosed with dry eye syndrome in primary care, the recommended first-line treatments involve a stepped approach, beginning with lifestyle measures, followed by the use of tear substitutes if symptoms persist ¹.

• Lifestyle Measures: Patients should be advised on lifestyle modifications for symptom relief ¹. This includes using warm compresses, practicing lid hygiene, and performing lid massage, particularly if blepharitis or Meibomian gland dysfunction is present ¹. Other recommendations include modifying contact lens wear, using moisture chamber eyewear (such as wrap-around glasses or specialist goggles), and adjusting environmental factors like increasing humidity, avoiding prolonged digital device use, and lowering computer screens ¹.
• Tear Substitutes ('Artificial Tears'): If lifestyle measures are insufficient for symptom relief, tear substitutes are advised ¹. People with mild-to-moderate dry eye symptoms should self-manage using over-the-counter topical preparations ¹. A wide range of tear substitutes are available over-the-counter in various formulations, including eye drops, gels, ointments, and sprays ¹. Low-viscosity drops are typically recommended for daytime use to reduce the risk of adverse effects like blurred vision, while increased viscosity ointments or gels may be needed for overnight use ¹. Examples of options include hypromellose and carbomers ¹. Where possible, preservative-free topical formulations should be advised, especially if the person is intolerant of preservatives, has moderate-to-severe dry eye requiring topical preparations more than four times per day, is using multiple topical eye preparations, or uses soft or hybrid contact lenses ¹.