Cataract eye drops for dry eye?

I had cataract surgery OD 11/3/11 and OS 11/11/11.  I noticed that while on the course of eye drops (steroid, Acular, antibiotic) that the miserable symptoms of redness and itching caused by chronic dry eye disappeared.  Once I finished with the eyedrops for the right eye first the redness and itching returned there.  I'm almost finished with the steroid drops for the left eye and dread a return to bilat. crimson, burning, itching eyes.

Can steriod eye drops ever be used long-term for this if eye pressure is monitored?  How about Acular alone?  Would Acular keep dry eye symptoms at bay (I've tried eye lubricants made specifically for dry eye, but they provide almost no relief)?  My eye specialist thinks my dry eye may be caused by a milder form of thyroid-related orbitopathy (I have normal TSH levels, so I won't get any help with thyroid medication).

[Houman Vosoghi, MD]

Really hard to agree with long term use of steroid drops given the high likelihood of steroid response glaucoma which is not always reversible after stopping steroids.  I would take a stepwise approach.  Acular is ok to continue for a while.  In addition, I would use preservative free artificial tears throughout the day and an ointment at night (Lacrilube, Muro 128 ointment, Puralube, are some examples).  You should also make sure you take Omega-3 supplements and apply warm compresses to your eyelids once a day (to deal with potential oil gland problems).  If all that is ineffective (works for 70% of my patients), you can ask your doctor to prescribe Restasis drops (takes 4-6 six weeks to see full effect).  Hope that is helpful.

HV