Dry Eye Disease: Evidence-based Evaluation and Management

by | September 6, 2023

Dry Eye Disease: Evidence-based Evaluation and Management

I recently underwent a series of treatments for dry eye syndrome. After not tolerating prescription eye drops and not finding much relief in behavioral and supplemental measures, I found that IPL (intense pulsed light) therapy significantly helped with my condition. 

Dr. Bojana Jankovic Weatherly with her optometrist, Dr. Shreya Patel
Dr. Bojana Jankovic Weatherly with her optometrist, Dr. Shreya Patel

As many of my patients suffer with the same condition, I wanted to share basic evidence-based principles of evaluation and treatment below:  

Common causes of dry eye disease:

  • It’s multifactorial: multiple causes can contribute to dry eyes
  • Generally, it’s due to decreased tear production or increased tear evaporation
    • Tear film dysfunction
    • Inflammation and damage of the eye surface

Risk factors:

  • Females
  • Advanced age
  • Hormonal change (esp low androgen levels)
  • Wearing contacts 
  • Certain medications s.a. antihistamines
  • Vitamin A deficiency
  • Eye surgery
  • Low humidity 
  • Autoimmune conditions s.a., Sjogren’s and Hashimoto’s thyroiditis
  • Other conditions, such as diabetes
  • Neurological and psychiatric conditions

Common symptoms:

  • Eye discomfort, feeling gritty eyes, burning, itching, watering or blurry vision


  • Artificial tears
  • Warm compresses
  • Frequent blinking and regular breaks from screens
  • Avoiding heat and AC when possible
  • Humidifier use
  • Prescription eye drops s.a. ophthalmic cyclosporine
  • Omega 3 fatty acids –  EPA+DHA although results are mixed PMID: 32917627; PMID: 30702470; PMID: 29652551
  • Supplemental antioxidants
  • Acupuncture
  • For dry eye disease due to meibomian gland dysfunction, IPL with meibomian gland expression has been shown to be an effective and safe additional treatment option PMID: 35737696; PMID: 36452044

Note: the above is not an exhaustive list

If you think you may have dry eye disease, have an evaluation with your optometrist and/or your ophthalmologist for appropriate work up and management. 

Do not start new supplements or treatments without consulting your physician, optometrist or a qualified professional.


Nothing stated or posted in this article is intended or should be taken to be the practice of medical or counseling care. The information made available in this article, including, but not limited to, interviews, text, graphics, images, links to other articles, websites, and other material contained in this article, is strictly for informational and entertainment purposes only. The information in this article is NOT (and should not be used as) a substitute for professional psychiatry, psychology, medical, nursing, or professional healthcare advice or services, nor is it designed to suggest any specific diagnosis or treatment. Please always seek medical advice from your physician or a qualified health care provider regarding any medical questions, conditions or treatment, before making any changes to your health care regimen, medications or lifestyle habits. None of the information in this article is a representation or warranty that any particular drug or treatment is safe, appropriate or effective for you, or that any particular healthcare provider is appropriate for you. Never disregard professional medical advice or delay seeking help from a health care provider due to something you have read or seen in this article. Your reading/use of this article does not create in any way a physician-patient relationship, any sort of confidential, fiduciary or professional relationship, or any other special relationship that would give rise to any duties. This article does not recommend or endorse any specific tests, healthcare providers, procedures, or treatments, and if you rely on any of the information provided by this article, you do so solely at your own risk.

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About the Author

Bojana Jankovic Weatherly, MD

Bojana Jankovic Weatherly, MD

Dr. Bojana (Boy•ana) Jankovic Weatherly is an award winning physician, double board certified in internal and integrative medicine. After completing internal medicine residency, she did a fellowship in integrative medicine, trained in functional medicine, nutrition and mindfulness. Her approach is rooted in evidence-based medicine that is personalized to each individual she works with.


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