Dry eyes are normally treated with hypromellose eye drops. However, the frequency of administration means carbomers (polyacrylic acid) - which cling to the eye surface - may be preferred by the patient. Other preparations in common use include polyvinyl alcohol, povidone eyedrops and paraffin-based eye ointments. Saline drops may be used by contact lens wearers who have a tear deficiency.

Dosage regimen

* Hypromellose eye drops require frequent (hourly) administration.

* Other eyedrop preparations are usually used up to four times a day, or when required.

* Paraffin-based eye ointments are usually used at bedtime.

Patient knowledge

* Check the patient understands how to instil the eye ointment or drops, and advise on technique if necessary. Some patients may benefit from a compliance aid, such as an eyedrop dispenser.

Is the medicine working?

* Does the patient feel that his or her eyes are less dry with the treatment? If not, refer back to the prescriber as an alternative may help more.

Side effects

* Paraffin-based preparations can cause blurring of vision, so should not be used before driving or other skilled tasks.

Monitoring

* Dry eyes can lead to conditions such as corneal scarring or infections. Patients should be advised to seek advice if they experience any of the following: photophobia, very red or painful eyes, a deterioration in vision.

Lifestyle

* Contact lenses should be avoided by patients with dry eyes, where possible.

* There are several things patients can do to reduce the symptoms of, and minimise complications as a result of, dry eyes. These include keeping the eyes clean, protecting the eyes from wind and hot air, reducing eye strain, using a humidifier, remembering to blink frequently and properly, and stopping smoking.

* There is some evidence that eating a diet high in omega-3 fats can help. These are found in oily fish, such as mackerel and salmon.

Ken P K Wan, community pharmacist, Clacton-on-Sea, Essex

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