I wonder how people who got dry eye will age. As you age dry eye symptoms tend to increase and can be associated with recurrent corneal erosions which, aside from being painful, can get infected, which can be absolutely terrible and vision threatening in extreme cases.
Dry eye is hell especially if you work at a computer.
As an aside, Ocusoft Retaine drops are the best thing I’ve found for dry eye; I’ve never met anyone else with the problem who uses them but it’s like night and day.
Eye drops do not treat the underlying cause of dry eye (unhealthy/insufficient tears, inflammation (e.g. blepharitis), or in rare cases neuropathic pain). They are just symptom relief.
For anyone reading this who manages their dry eye with eye drops, please do some reading or see a specialist. If all you do is use eye drops, your dry eye will likely get worse.
Eye drops bolster your tear film and help prevent desiccating stress to the eye surface, but they lack growth factors and other important compounds found in biological tears, and can even contribute to washing those away.
Last, whatever you do, don't use eye drops with preservatives (e.g. benzalkonium chloride).
How many quality opinions did your friend get? I also know people with DED and from my experience not all docs understand the disease well. Obviously you know more than I do, but I'm very skeptical that there isn't more to the story than "a lifetime of drops". Also, I hope your friend has tried autologous serum drops.
That is a great suggestion IMHO. ASTs are pretty amazing but they're not a cure for everyone.
In the case above, I'm referring to my spouse. Her entire family has this problem - dry eye, frequent / continuous corneal erosions - setting in by their mid-late thirties. These are the people who end up wearing sleeping goggles, ointment, taping their lids shut, etc. It's not a lack of tear production, it's poor corneal basement layer adhesion for some undiagnosed reason and, probably, eyelids drifting open during sleep.
Dry eye is hell especially if you work at a computer.
As an aside, Ocusoft Retaine drops are the best thing I’ve found for dry eye; I’ve never met anyone else with the problem who uses them but it’s like night and day.