How should I approach the management of dry eye syndrome in patients w

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Management of dry eye syndrome in patients using contact lenses should include:

Advise modification of contact lens wear by reducing wearing time and removing lenses if dry eye symptoms occur to help alleviate discomfort .
Suggest changing the type of contact lenses or lens solutions, and recommend consultation with an optometrist for tailored advice .
Recommend preservative-free tear substitutes where possible, especially for contact lens users, to reduce the risk of allergic or toxic reactions associated with preservatives .
Use low-viscosity tear drops during the day to minimize blurred vision and discomfort, and consider more viscous ointments or gels for overnight use .
Advise on lifestyle measures such as warm compresses, lid hygiene, and lid massage if blepharitis or Meibomian gland dysfunction is present, which can contribute to dry eye symptoms .
Consider moisture chamber eyewear (e.g., wrap-around glasses or specialist goggles) to protect the ocular surface from environmental factors that exacerbate dry eye .
Encourage modification of environmental factors, such as increasing humidity, avoiding air conditioning or drafts, and reducing prolonged digital device use to improve symptoms .
Arrange follow-up within 4–6 weeks after starting tear substitutes to assess symptom relief and consider switching to alternative preparations (e.g., sodium hyaluronate or lipid-based) if symptoms persist .
If symptoms do not improve after 4–12 weeks of primary care management, consider referral to a specialist for further assessment and treatment .

How should I approach the management of dry eye syndrome in patients who are also using contact lenses?