For a patient with a SPEED score of 4 and symptoms of dry eyes, what is the best recommendation?

The best recommendation is to suggest low-viscosity artificial tear drops and have the patient return to the pharmacy in 2-3 weeks. This choice is appropriate for a patient scoring a 4 on the SPEED score, which typically indicates mild to moderate dry eye symptoms. Low-viscosity artificial tear drops are designed to provide adequate lubrication for individuals with such symptoms while being less likely to cause blurriness compared to higher viscosity options.

These drops can be used frequently throughout the day, which is ideal for managing mild to moderate dry eye symptoms effectively. The recommendation to follow up after a few weeks allows for assessment of the patient's response to treatment and potential adjustment of therapy if necessary. It reflects a stepwise approach, starting with over-the-counter solutions before considering more intensive interventions.

Higher viscosity options may provide longer-lasting relief but can also cause more blurriness, which may not be suitable for all patients, especially those experiencing only mild symptoms. Immediate referral to an eye care specialist may be excessive unless there are other concerning findings that suggest a serious underlying condition, such as Sjögren's syndrome, which would typically require more evidence or additional risk factors before making such a referral.