I'm certainly not an expert, and I'm still struggling a lot. I have good days where I feel almost completely normal and then I have bad days where I can't see anything unless I hold it three inches from my face (works for a phone, not so effective with a computer screen) and I want to cry in frustration.
I've got my basic arsenal down and it's actually pretty simple for now. I'm attacking on a few different fronts. I did some frantic online research/shopping when I decided to get serious about this (oh, the irony of having to use the computer to find information about a condition that is worsened by using the computer!).
Humidifier - (x2 - one for my office, one for the bedroom). This one was the cheapest, simplest humidifier I could find and it's been great. The misty air is cold, which means you can have an unpleasant tendency to dampness if you aim it too close to your clothes. I'm honestly not sure if the humidifier is making a huge difference, but it's a relatively low cost, low impact option, so I'm sticking with it.
Eye drops - I use two different kinds of eye drops, a lighter one during the day and a heavy gel at night. They are both preservative free, which is critical if you're using them often. They come in individual vials, which are meant for single use but I can recap my daytime ones and get a few applications out of each one. I use RefreshPlus during the day, which I get from Costco for a little less money ($20 for 100 vials, which lasts me about a month) and before I go to bed at night I put in Thera Tears gel, close my eyes and sort of massage it in. Then I carefully wipe my eyes with damp washcloth, because I hate having gel all over my eyelashes when I wake up.
Omega-3s - I'm taking vitamins for the first time in my life. There is some evidence that omega-3s can help with dry eyes (some studies here). I figured I should be taking them for general health anyways, so that was an easy decision. And since I was already in for it, I added in a vitamin B complex and the vitamin D my doctor asked me to start taking 5 years ago. I'm basically the healthiest person alive now! Right now I'm just using the Thera Tears vitamin, because I was overwhelmed and tired of researching things. Since the omega-3 is the important part I'll probably save a little money and just start sharing the Costco fish oil pills that we buy for Circe (yes, our dog has been taking all her supplements daily since we've had her - not sure why it takes a crisis to convince me to do the same). It can take 4 - 8 weeks before you notice an improvement. Last week was my fifth week and I felt like I turned a little corner. It was the first week in months where I felt pretty normal all week. I don't want to jinx it, but I'm hopeful. This week I've had a little blurring but nothing terrible. I'm now obsessive about never missing my pills and I wish I'd tried this earlier.
Hot/cold compresses - There's some debate over compresses. People generally recommend a hot compress to help unplug (possibly) blocked oil ducts. On the other hand, some people swear by cold compresses to help reduce inflammation. I go ahead and do both. I store my gel eye mask in the freezer and when I get home from work I take out my contacts* and do a 10 - 20 minute cold compress. I leave the mask out and then right before I go to bed I'll heat it in the microwave and do a 10 minute hot compress. Again, not sure this helps but it feels good. The mask is relatively cheap and it's been holding up well so far.
I've had temporary punctal plugs inserted twice now and they seem to help me quite a bit but I think the left one came out shortly after it was inserted this time around. My left eye (which was my good eye for the first few months) has been a disaster, way worse than my right. FYI - the punctal plugs aren't scary at all. Each one looks like a tiny grain of rice and it takes about two seconds for the ophthalmologist to pop it into the tear duct. They dissolve slowly and mine are supposed to last about 3 months but don't make it quite that long. I have a little discomfort right after insertion (not painful, but I'm aware of it) but they seem to settle in overnight and then I can't tell they're there.
Eyelid hygiene is usually recommended. I don't worry much about this, because I wash my face every night with gentle soap and do a pretty thorough massage of my eyelids to make sure I get all my mascara off.
Work habits are the toughest for me. The rule I keep hearing is take a break from computer work every 20 minutes and look at something 20 feet away. I don't know about you, but that's difficult for me. First, I guess I should be setting an alarm to go off every 20 minutes, but I haven't done it. Second, I tend to get really focused and then I hate being interrupted when I'm working on something. (I'm fully aware these are excuses - I'm going to set up the alarm on my phone now)
I have been trying to reduce my screen time as much as possible. I don't use the computer much for recreational stuff if I'm having a bad spell (hence, sporadic posting). Sadly, reading is sometimes difficult as well and I have to be more strategic about it. I'm going to look into checking out audio books from the library if I don't improve soon.
Upcoming - at my last ophthalmologist appointment he recommended permanent punctal plugs and Restasis prescription eye drops. I resisted because I felt I hadn't done everything I could on my end. But after 1.5 months of effort, I'm ready to go try anything. I'll probably take him up on those at my next appointment. But maybe not the permanent plugs because those still make me nervous (what if I don't have insurance at some point and that's when a plug decides to go rogue in my tear duct?!).
* And this is maybe where you want to yell at me, because I'm still wearing contact lenses against the advice of my ophthalmologist. He thinks that my dry eyes are caused by contacts but I'm not so sure. I followed his advice initially and went completely without contacts for a month ... and then another month ... and then another month. It didn't make an appreciable difference in my eye situation. I seem to have about the same number of good and bad days whether I'm wearing contacts or glasses. One side effect of the dry eyes is that I'm pretty sensitive to bright light and being able to easily slip sunglasses on and off is a huge benefit. I also just hate wearing my glasses, especially at the gym. I am extremely careful with my contacts, never sleep in them and change them out as scheduled. I feel pretty confident that this isn't setting me back, but who knows? One thing I've found really helpful - I put a daytime eye drop (RefreshPlus) in each eye right before putting my contacts in. Then I put an eyedrop in the contact lens before I insert it and follow the whole thing up with an eyedrop in each eye. My eyes don't dry out any faster when I'm wearing contacts (I have soft hydrogel lenses) and it's much easier for me to put eyedrops in because I'm not having to take my glasses off each time. Have I justified my vain and potentially bad decision enough now?