If dry eye symptoms persist after regular use of carbomer gel, which of the following would be the most appropriate next step in treating dry eyes?

• A. Lacrimal Plugs
• B. Sodium Hyaluronate
• C. Corticosteroid Eye Drops
• D. Antibiotic Eye Drops

Answer: (B)

Dry eye treatment aims to restore a stable tear film and lasting lubrication. If symptoms persist despite regular use of a lubricant gel, the next step is to switch to a lubricant with superior hydration retention and tear-film stability. Sodium hyaluronate fits this need because it’s a natural component of the tear film with high viscoelasticity and water-binding capacity. This allows it to form a more durable, protective layer on the ocular surface, reducing evaporation and friction and often improving tear-film break-up time. It can be used in various concentrations and molecular weights, enabling customization for sensitivity and severity, and it tends to provide longer-lasting relief with less blurred vision after instillation compared with some other gels. In contrast, lacrimal plugs are more appropriate for significant aqueous deficiency or when lubrication alone isn’t enough; corticosteroid drops address inflammation but carry risks with long-term use and aren’t first-line for chronic dry eye; antibiotics target infection rather than lubrication unless an infectious component is present. So, shifting to sodium hyaluronate offers a practical, effective next step to improve comfort and surface protection in persistent dry eye.