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  • Treatment

Dry Eye Treatment Costs

  • Last updated November 8, 2022

7 min read

Jovi Boparai MD Profile Picture
Written byJovi Boparai, MD
J. David Stephens, MD
Reviewed by J. David Stephens, MD
Jovi Boparai MD Profile Picture
Jovi Boparai, MDCo-founder & CEO of CorneaCarePhiladelphia, PA

Bio

Dry eye disease is tough! I get it. I have struggled with dry eyes for several years from contact lens use, and from spending countless hours looking at computer screens. In college, my dry eyes got so bad that I couldn’t wear contact lenses, because of a constant “foreign body sensation” when I had them in. I had to stop reading every 30 minutes because my eyes would start to burn and my vision would get blurry. I tried a plethora of treatments and nothing seemed to work. Dry eye disease was not only impacting my eyes, but also my emotional wellbeing. It was preventing me from enjoying life, and getting in the way of my professional training. I felt overwhelmed, frustrated and hopeless.

It was only when I realized that my dry eyes were linked to my lifestyle, environment and overall health did things start to make sense. I noticed that on days when I spent less time on the computer, my eyes felt better. My symptoms would flare when it was windy, or when there was low humidity. I knew that if I wanted to get ahead of my dry eyes, I needed to not only treat my eyes, but to also address my lifestyle. I started a consistent regimen of artificial tears and eyelid hygiene. I switched from monthly contact lenses to daily contact lenses. I started taking scheduled breaks from looking at a computer. I ate a healthier diet focused on anti-inflammatory/antioxidants foods, and I bought a humidifier for my room. In the beginning doing all this seemed impossible, but over time it became part of my usual routine. Not only did my eyes feel better, but I was overall healthier and happier! Turns out what is good for my eyes, was also good for my mind and body. I carried this lesson with me as I started my career to become an ophthalmologist and ophthalmic surgeon.

Because of my personal journey and professional training, I believe dry eye treatment starts by listening to and empowering the patient. I listen for the struggles and cue in on their strengths, while picking up on their lifestyle. Only then do we together start building a treatment plan that incorporates good eye hygiene with small, but impactful lifestyle changes. Our sight is our most important sense, and it is intimately linked to our very being. I want dry eye patients to not only get their dry eyes under control, but to also enjoy good mental and physical health, and live a fulfilling life. What is good for the eyes should also strengthen the mind and fortify the body!

Get to know me a little better!

Hobby: vintage watches
Food: peanut butter
Superhero: Superman
Guilty pleasure: desserts
Secret power: has never had a headache

Training:

Undergraduate: University of Pittsburgh Honors College
Medical school: Weill Cornell Medicine
Ophthalmology residency: Wills Eye Hospital.

J. David Stephens, MD
J. David Stephens, MDOphthalmic SurgeonFort Myers, Fl

Bio

Dr. Stephens is a fellowship trained cornea specialist with extensive expertise in ophthalmology. By combining his clinical and surgical skills with strong relationships, Dr. Stephens is able to provide excellent care tailored to his patients’ specific needs. Through his clinical practice, Dr. Stephens has come to appreciate the multifactorial nature of dry eye disease, and how it can be a byproduct of a patient’s ocular and medical history, environment and lifestyle. He continually strives to provide personalized care, and believes that dry eye treatment needs to address both the physical and emotional needs of the patient.

Get to know Dr. Stephens a little better!

Hobby: ping pong
Favorite food: tex mex
Superhero: Deadpool
Guilty pleasure: sour candy
Greatest weakness: instantly sunburns
Secret power: free throw shooting

Training:

Medical school: University of Oklahoma
Ophthalmology residency: Wills Eye Hospital
Cornea fellowship: Vance Thompson Vision

Dry eye treatment costs - your vision is priceless

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Table of Contents

Key points

  • A patient with dry eye disease can spend $750 – $2,200 per year on treatment.
  • Dry eye prescription drops often require prior-authorization from insurers and in-office procedures can cost anywhere from $500 – $1500 per procedure.
  • Being consistent with a simple regimen may be better than pursuing temporary prescriptions and procedures.

Keywords

Artificial tears, eye ointment, over the counter eye drops, prescription eye drops

Taking the first step

Dry eye disease (DED) can physically, emotionally, and financially affect you. People suffering from DED can spend hundreds to thousands of dollars a year on eye drops for dry eyes, office visits, in-office procedures, and dry eye prescription drops. Not to mention, the lost days of work and the cost of commuting to and from eye doctors (ophthalmologists and optometrists). We here at CorneaCare want to help you get dry eye relief, while keeping the cost of dry eye treatment in check. We make your eye care and eye health a priority.

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A quick review of dry eye disease

Before getting into the cost of DED, let’s review some basics. DED is also known as dry eye syndrome, keratoconjunctivitis sicca and ocular surface disease.1 The classic dry eye symptoms are blurred vision, light sensitivity, itchy eyes, eye strain, dryness, watery eyes, stinging or burning, gritty sensation and eye pain. 

There are several causes of dry eyes, but we break them down into aqueous deficient and evaporative. With aqueous deficient DED, your lacrimal glands do not produce enough natural tears to lubricate the surface of the eyes (the cornea and conjunctiva). With evaporative DED, your body makes enough natural tears, but they evaporate too quickly. In reality, most forms of DED are a combination of aqueous deficient and evaporative, leading to tear film dysfunction. 

Causes of dry eye disease

The treatment options for dry eye include over-the-counter (OTC) lubrication with eye drops (artificial tears), gels, ointments and eyelid hygiene (warm compress and eyelid wipes). A humidifier and air purifier can also help, as can using an  oral dry eye supplement. In addition to lubricating eye drops, a person may require dry eye prescription drops and in-office ophthalmic procedures.

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Over-the-counter eye drops for dry eye

Artificial tears are the most common eye drop for dry eyes. They come in two varieties: those with preservatives (most common), and those without preservatives, aka preservative-free. The most common preservative is called benzalkonium chloride (BAK).2 While preservatives make the artificial tears last longer on the shelf, they can have adverse effects on the surface of the eye. The typical artificial tears with preservatives can cost $6 – $16 for one bottle. Most preservative-free eye drops will typically range from $17 – $32 for a 30 day supply (single-use vials or bottles).

Dry eye artificial tears

Other eye drops for dry eyes available over-the-counter include antihistamine drops (to reduce itchiness), “red eye” drops (to reduce eye redness), and drops containing menthol (to provide a cooling sensation). In general, most of these drops will contain preservatives, and can be harmful to the surface of your eyes in the long run.   

The important thing to understand is that there is no “best eye drop” to treat dry eyes. Typically, using preservative-free eye drops is better for the eyes, especially if you’re using drops more than 3-4 times a day. The “best eye drop” is the one that works for you, and is used consistently!

Gel and ointment for dry eyes

Eye gels and ointments can be an excellent option for individuals who wake up with dry eyes.3 You can develop dry eyes overnight for various reasons, and nightly gels and ointments can help prevent this. It’s best to use them right before bedtime because they can significantly blur your vision. Ointments are thicker than gels, and will therefore blur your vision more. For individuals with severe dry eyes, we sometimes recommend gels and ointment during the day as well. Eye gels and ointments typically range from $8 – $20.

Dry eye warm compress and eyelid hygiene

In addition to lubricating the surface of your eyes with tears, gels and ointments, taking care of your eyelids is also an important eye treatment. In fact, the eyes and eyelids work together to maintain your tear film. Taking care of your eyelids typically requires warm compresses and/or eyelid wipes and sprays. You can either make a warm compress at home, or purchase a pre-made one for approximately $15 – $20. Alternatively, you purchase one-time use warm compress masks that are hygienic, don’t require water or a microwave, but still deliver a therapeutic warmth. Eyelid wipes can cost anywhere from $10 – $20 for a 30 day supply, with higher quality wipes costing $25 or more. Eyelid sprays can range from $20 – $30.

Eyelid hygiene routine: warm compress, eyelid wipes, eye mask

Dry eye prescription drops

When OTC treatments don’t work, dry eye patients often turn to dry eye prescription drops.4 These include cyclosporine (Restasis and Cequa), and lifitegrast (Xiidra). These prescription drops work by improving tear production and reducing inflammation. In severe cases or during symptom flare-ups, we sometimes use loteprednol (Lotemax and Eysuvis), a low-strength topical steroid drop, to rapidly alleviate symptoms.  Most recently, the FDA also approved a varenicline nasal spray (Tyrvaya), which increases natural tear production. 

There are two main issues with dry eye prescription drops. One, it’s important to realize that prescriptions are not a magic cure, and that they work best when used alongside an overall treatment plan. Two, many insurance providers will not cover dry eye prescription drops without prior authorizations, making it difficult to obtain coverage for some patients. The prior-authorization process can often take months.

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It’s difficult to determine the costs of dry eye prescription drops because of the considerable variation in insurers and insurance plans. But typically, most come with a copay, which can range from $5 – $60. You may also have to pay for a portion of the prescription cost. And if your insurance doesn’t cover the dry eye prescription drops, then the out-of-pocket expense is astronomical, upwards of $600 per month.

Dry eye supplements

Dry eye supplements can be a great addition to your overall treatment plan. Several key nutrients can help in dry eyes, including Omega-3 fatty acids, beta carotene (precursor for Vitamin A), coenzyme Q10, zinc and copper, vitamin E, vitamin C, vitamin B6, vitamin B12 and vitamin D. Most oral supplements for dry eyes range from $20 – $90, but typically don’t contain all the necessary nutrients. 

The environment plays a critical role in DED, and so other “supplements” include air purifiers ($50 – $250), humidifiers ($30 – $150), moisture chamber glasses ($35 – $100) and nighttime eye goggles ($30 – $75).5

Dry eye punctal plugs and other procedures

In cases where eye drops, gels, ointments, supplements and prescriptions don’t cut it, some patients turn to in-office procedures.6 The most common approach is punctal plugs, which are placed into your tear drainage system in the eyelids. Punctal plugs block your tear drainage system, allowing for tears to stay longer in your tear film.  Other procedures include different devices and gadgets to address your eyelids, and specifically the meibomian glands (oil glands that line the eyelid and are responsible for the lipid layer of your tear film). These procedures are intense pulsed light (IPL) therapy, LipiFlow, iLux, TearCare, BlephEx, Thermoflo and NuLids. In very severe cases, amniotic membranes can be placed on the ocular surface to reduce inflammation and assist in healing.

prescriptions and procedures: eyelid thermal heating devices, punctal plugs, prescription eye drops

Aside from punctal plugs and amniotic membranes, most in-office procedures for DED are not covered by insurance. Therefore, you have to pay out-of-pocket, and the price can range from $500 – $1,500 depending on where you live. 

While in-office procedures could be a good option, there are two issues with them. One is the lack of price predictability and transparency for these procedures. The price can vary dramatically depending on your location. The other is that these procedures are often marketed as quick fixes, but typically you need the procedure done multiple times. Moreover, just like with prescriptions, in-office procedures work best when used alongside a good overall treatment plan.

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Dry eye contacts

Wearing contact lenses can cause dry eyes, while DED can lead to what’s called “contact lens intolerance” (the inability to wear contact lenses). Oftentimes, people who develop DED in contacts can try switching to daily contact lenses (discarded at the end of each day). However, this comes at an additional cost. While monthly contact lenses can cost $360 – $450 per year, daily contact lenses can cost $720 – $960 per year.7 

In some cases, we may try scleral contact lenses, which are larger than your usual contact lenses. Scleral lenses cover a larger area over the cornea and provide a “moisture chamber” which prevents the ocular surface from drying out. Scleral lenses are typically custom-made and not covered by insurance. They can cost from $1,200 – $2,000.

Office visits for dry eyes

The average DED patient can have anywhere from 4 to 12 clinic visits a year! These are days when you might have to miss a half or full day of work. You also have the added stress and expense of traveling to and from the clinic. Depending on where you live, you may have to travel long distances to find an eye doctor, let alone a dry eye specialist. And when you finally get to the clinic, you have to deal with your co-pay, which can range from $10 – $100. 

The cost of dry eye disease on the US healthcare system and society

Between office visits, prescription medications and procedures, the healthcare expenditure on DED is around $25 billion a year.8 Relatedly, the societal cost is nearly $55 billion a year, which includes lost wages, decreased work productivity, anxiety and depression associated with DED, traveling costs to and from clinic visits.

These are huge numbers, but they make sense. Nearly 30 million Americans suffer from dry eyes, and the related cost of dry eye treatment really add up.

Putting it all together

DED can impact you emotionally, physically and financially. The average dry eye patient can spend $750 – $2,200 a year on treatment to seek dry eye relief.9 However, this increased spending hasn’t necessarily translated into better care. In fact, 50% of DED patients report that their providers underestimate their symptom severity,10 and between 50-65% are dissatisfied with their treatment.11 Oftentimes, a personalized regimen that relies on OTC treatments may be sufficient, if done consistently. Prescriptions and procedures can be a great addition, but only if used as part of an overall treatment plan. Let’s come up with a treatment plan that addresses your physical and emotional needs, but also fits into your financial budget!

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What’s next

We really think everyone should take our Dry Eye 101 course. Find it here!

If you’ve already taken it, amazing! Check out more articles in the Continuing Education section below.

Bibliography

  1. Tear Film & Ocular Surface Society. Dry Eye Workshop II Report. Ocular Surface Journal, 2017. TFOS DEWS II Report, https://www.tfosdewsreport.org/.
  2. Goldstein, Michael H., et al. “Ocular benzalkonium chloride exposure: problems and solutions.” Eyes, 2021. Nature, https://www.nature.com/articles/s41433-021-01668-x.
  3. Caceres, Vanessa. “Guide your patients toward better gel and ointment use.” ASCRS Eye World, 2008, https://www.eyeworld.org/2008/guide-your-patients-toward-better-gel-and-ointment-use/. Accessed 11 October 2021.
  4. Godman, Heidi. “Eye Drops for Dry Eyes.” Healthline, 2019, https://www.healthline.com/health/great-eye-drops-dry-eyes#_noHeaderPrefixedContent. Accessed 12 September 2021.
  5. Muncy, Leah. “How to Treat (and Prevent) Dry Eyes, According to Eye Experts.” The Strategist, 2021, https://nymag.com/strategist/article/how-to-treat-dry-eyes.html. Accessed 17 September 2021.
  6. Dry Eye Directory. “Ultimate Guide to Dry Eye Treatments in 2021.” Dry Eye Directory, 2021, https://dryeyedirectory.com/dry-eye-treatment/. Accessed 15 September 2021.
  7. Heiting, Gary. “How much do contact lenses cost?” All About Vision, 2021, https://www.allaboutvision.com/contacts/faq/contact-cost.htm. Accessed 11 October 2021.
  8. Yu, Junhua, et al. “The Economic Burden of Dry Eye Disease in the United States: A Decision Tree Analysis.” Cornea, vol. 30, no. 4, 2011, pp. 379-387. Wolters Kluwer, https://journals.lww.com/corneajrnl/Abstract/2011/04000/The_Economic_Burden_of_Dry_Eye_Disease_in_the.2.aspx.
  9. Chan, Clara, et al. “Economic burden and loss of quality of life from dry eye disease in Canada.” BMJ Open Ophthalmology, 2021. BMJ, https://bmjophth.bmj.com/content/bmjophth/6/1/e000709.full.pdf.
  10. Asbell, Penny A., and Scott Spiegel. “Ophthalmologist Perceptions Regarding Treatment of Moderate-to-Severe Dry Eye: Results of a Physician Survey.” Eye & Contact Lens: Science & Clinical Practice, vol. 36, no. 1, 2010, pp. 33-38. Wolters Kluwer, https://journals.lww.com/claojournal/Abstract/2010/01000/Ophthalmologist_Perceptions_Regarding_Treatment_of.7.aspx.
  11. Dubey, A., et al. “Treatment Patterns and Satisfaction in Dry Eye Patients in Real-World Practice Setting.” Investigative Ophthalmology and Visual Science, vol. 51, no. 13, 2010. ARVO Journals, https://iovs.arvojournals.org/article.aspx?articleid=2374860.

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