You may need a course of prescribed medication depending on your condition. If there is a marked bacterial over-growth, and obviously if there is any sign of bacterial eye infection, we will put you on a course of antibiotics drops or ointment.
We sometimes recommend a course of oral antibiotics similar to the manner in which they are prescribed for rosacea or acne. In this case, the antibiotics are used at a low dose which is not treating any infection, although it does reduce the bacterial load, but is used for its anti-inflammatory properties. A 3-month course of treatment is typical.
Steroid eye drops are a useful short term treatment to get inflammation under control. Most people with dry eye have some degree of inflammation so it makes sense to kick start the healing process. If we have recommended Blephex and/or IPL we may wait until after those treatments before starting a short course of steroid eye drops. There are a number of drops available so, depending on the severity of your signs and symptoms, we will prescribe the appropriate strength for you. There is only one type of preservative-free steroid drop available which is significantly more expensive than the others. We have that as an option where sensitivity to preservatives is likely to be an issue.
Steroids are not a long term option and should not be used on an ad hoc basis. There is a risk that the pressure in the eye can rise when steroid eye drops are being used so this is something that needs to be monitored especially when high strength drops are used.
There are other more specialised drops that can also be used in difficult cases. There is less availability of medications in Australia compared to America but some can be made in a compounding pharmacy.