How Immune Modulating Eye Drops Can Reduce Inflammation

Reviewed by: HU Medical Review Board

Chronic dry eye is a disease of the surface of the eye that can happen when your eye does not make enough tears, or there is an issue with the tears that are made. Chronic dry eye may also be called dry eye, dry eye syndrome (DES), dry eye disease (DED), or keratoconjunctivitis sicca.1

Chronic dry eye can cause a vicious cycle of inflammation. If the surface of the eye is inflamed, damage can happen to the glands that make tears, the tissues on the surface of the eye, and even the eyelids. Immune-modulating eye drops work to stop this inflammation.2

How do they work?

The smooth, wet surface of the cornea helps to focus light through the lens and onto the retina for vision.3

The ocular surface provides protection and smooths the outer layer of the eye. This allows for clear vision and ease of blinking. The ocular surface includes various tissues, glands, and moisture, including the tears, tear glands, and the outer tissues of the eye.3

When the ocular surface is inflamed, tear production is impacted and may lead to chronic dry eye.3

Recent studies have looked at the causes of chronic dry eye and the effects of anti-inflammatory treatments. These studies looked at inflammatory markers in the tear film and tissues of the ocular surface. However, the exact role of these markers is not clearly known. In some cases, inflammatory markers decreased with certain anti-inflammatory treatments. However, doctors do not understand exactly how these treatments work in chronic dry eye.4

It is difficult for healthy cells to grow in an environment that is always inflamed. Decreasing inflammation on the ocular surface can lead to better functioning of the glands that make tears and help overall healing. Anti-inflammatory eye drops may be especially helpful for dry eye linked to autoimmune diseases, such as in Sjögren’s syndrome.2


There are several different brands of immune modulating eye drops, including:5-7

  • Restasis® (cyclosporine ophthalmic emulsion)
  • Cequa™ (cyclosporine ophthalmic solution)
  • Xiidra® (Lifitegrast ophthalmic solution)

There are different directions for using each of these eye drops. Steroid eye drops can also be used to decrease ocular surface inflammation. However, steroid eye drops are not as specific as immune modulating eye drops. Be sure to talk to your doctor about dosing and whether these drugs are right for you.

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking. The most common side effects of immune modulating eye drops include:8

  • Redness, stinging or burning, or general irritation of the eye
  • Blurred vision or other vision changes
  • A sensation that something is in your eye
  • Headache

These are not all the possible side effects of immune modulating eye drops. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with immune modulating eye drops.

Additional treatment options

In addition to immune modulating eye drops, there are other treatments available for the signs and symptoms of chronic dry eye. Some of these include:1

Chronic dry eye can be severe and impair many aspects of your daily life. Your doctor will examine your eyes, ask you questions about the symptoms you are having, and work with you on the best treatment.

Before beginning treatment for chronic dry eye, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

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