Dry Eye Management
Classify the subtype and severity from symptoms and signs, then get a TFOS DEWS II staged plan — drops, lid therapy, anti-inflammatories, punctal plugs, IPL/thermal pulsation and combinations — with product names and prescribing scope.
Decision support only — not diagnosis or prescribing
How this tool works, clinical basis & references
How this tool works
- Diagnostic gate: confirms dry eye when symptomatic (OSDI ≥13) coincides with ≥1 positive homeostasis marker (TBUT ≤10 s, osmolarity ≥308 mOsm/L, or positive staining).
- Subtype: triages evaporative/MGD (lid & lipid signs, short TBUT) versus aqueous-deficient (low Schirmer, Sjögren’s); mixed when both; defaults to evaporative/MGD when equivocal, as it is the most common driver.
- Severity: OSDI band plus sign magnitude → mild / moderate / severe — a labelled aid, since DEWS II has no numeric grid (the 4-level grid is DEWS I).
- Plan: maps to the DEWS II 4-step ladder and adds subtype- and inflammation-directed options plus the standard combination bundles, each flagged with prescribing scope (optometrist Rx / in-office / refer).
- Copy-out: generates a de-identified clinical/GP or plain-language patient summary. No patient identifiers are entered or stored.
Diagnosis follows the DEWS II gate (symptoms OSDI ≥13 plus ≥1 homeostasis marker — TBUT ≤10 s, osmolarity ≥308 mOsm/L, or positive staining). Subtype is triaged from lid/lipid signs (evaporative/MGD) versus volume tests (aqueous-deficient), defaulting to evaporative/MGD where equivocal because it is the most common driver; most chronic disease is mixed. Management follows the DEWS II 4-step ladder, additively. Severity→step is a labelled pragmatic aid — DEWS II has no official numeric grid (the 4-level grid is DEWS I). Framework is TFOS DEWS II (2017); DEWS III began publishing in 2025 and a reconciliation pass is a future review task. Values and wording require practitioner review before wider promotion.
Intra-app resources
Evidence base
- TFOS DEWS II — Definition & Classification (Craig 2017)
- TFOS DEWS II — Diagnostic Methodology report
- TFOS DEWS II — Management & Therapy report
- AAO Preferred Practice Pattern — Dry Eye
- ASCRS ocular-surface algorithm (Starr 2019)
- Access to dry eye treatments in Australia (Insight)
- TFOS DEWS II — Management & Therapy report
- Cochrane — Artificial tears for dry eye (2016)
- NovaTears/EvoTears (perfluorohexyloctane) available AU
- DREAM study — omega-3 for dry eye (NEJM 2018, negative)
- Xdemvy (lotilaner) — FDA-only, not TGA-approved
- Ikervis ciclosporin PBS-listed (Optometry Australia)
- Lifitegrast (Xiidra) on AU optometry schedule
- LipiFlow thermal pulsation (J&J Vision)
- Lumenis OptiLight — FDA-cleared IPL for MGD
Framework and thresholds from TFOS DEWS II; population reference values for deterministic, explainable guidance — not diagnosis. Sources reviewed 22 July 2026. Clinical wording, thresholds, product labels and PBS criteria require practitioner review before wider release.
Products & brands available in Australia (49)
Preservative-free aqueous / HA lubricant
4- Bion Tears
- Hylo-Forte 0.2% / Hylo-Fresh 0.1%
- PF Refresh / Systane unit-doses
- Thealoz Duo — trehalose + HA
Lipid-based / liposomal / perfluorohexyloctane lubricant
5- Cationorm — PBS-listed
- Liposomal sprays — Tears Again
- NovaTears / EvoTears — F6H8
- Optive Fusion / Optive Advanced
- Systane Complete / Systane Balance
Warm compress + lid hygiene
4- Blephasteam
- Bruder / moist-heat mask
- OcuSoft lid scrub
- Sterilid / hypochlorous acid — Avenova
Oral omega-3 supplementation
3- flaxseed — vegetarian
- high-strength fish oil
- Lacritec
Tea tree oil / terpinen-4-ol lid hygiene (Demodex)
4- Blephadex
- hypochlorous acid spray
- Sterilid
- tea-tree lid wipes
Topical ciclosporin (immunomodulator)
3- Cequa 0.09% BD — PBS Authority
- Ikervis 0.1% nocte — PBS Authority
- Restasis 0.05% — SAS only
Topical lifitegrast (LFA-1 antagonist)
1- Xiidra 5% BD — private script, not PBS
Short-term topical corticosteroid (induction / flare)
2- Fluorometholone (FML) 0.1%
- Loteprednol (Lotemax) 0.5%
Punctal occlusion (tear conservation)
2- Collagen/dissolvable — diagnostic trial
- Silicone punctal / intracanalicular
In-office thermal pulsation / gland expression
4- Blephasteam
- iLux / Systane iLux
- LipiFlow
- TearCare
Intense pulsed light (IPL)
3- E-Eye
- Lumenis OptiLight — FDA-cleared for MGD
- M22
Low-level light therapy / photobiomodulation (adjunct)
3- Celly
- Eyelight / My-Mask
- Marco Equinox
Blepharoexfoliation (lid-margin debridement)
3- AB Max
- BlephEx
- NuLids
Oral doxycycline / azithromycin (anti-inflammatory) — refer
2- Azithromycin — pulsed
- Doxycycline 40–100 mg — sub-antimicrobial
Autologous serum eye drops
1- Autologous serum 20–100% — compounded
Scleral / bandage contact lenses
2- Bandage soft lens
- Scleral lens
Amniotic membrane / surgical measures
3- Prokera / dehydrated AM
- Surgical punctal occlusion
- Tarsorrhaphy
OptoGuide is not an advertising platform. This is a clinical reference — a brand↔active-ingredient lookup and a list of options available in Australia — sorted alphabetically by type. OptoGuide’s recommendations are based on scientific evidence and clinical appropriateness; they cannot be bought, promoted, or reordered by sponsorship, and inclusion here is not endorsement. Always verify current registration, PBS status and suitability for your patient.
Help keep this reference accurate
Spotted a missing product, a registration or PBS change, or an error? Manufacturers, distributors and clinicians are all welcome to let us know so we can keep this list current. Listing is a neutral clinical reference — it does not affect OptoGuide’s recommendations, which are based on evidence and cannot be bought or reordered by sponsorship.
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