Question: How are the most severe cases of dry eye treated?
Answer: The most severe cases of dry are often very challenging. Here at the Wilmer Eye Institute at Johns Hopkins University, we have a specialty dry eye clinic where these patients are seen by corneal specialists and often there are surgical interventions.
If the lids are not exactly in the right position lid surgery can be very helpful. Amniotic membrane transplants can temporarily and long term protect the ocular surface. In addition, we often use specialty contact lenses. Bandage lenses that retain moisture throughout the day. Or very large scleral lenses which cover the entire eye and filled with a reservoir of fluid are placed on the eye to protect the severe cases.
Immunosuppressants can often help as well. Our corneal specialists will individualize the treatment for that person who is not getting good control with the treatments we mentioned earlier. Do follow up if you're not being happy with your current treatment.