Dry Eye Center Of Excellence By Dr. Steven Chander on April 19, 2010

How To Fix Dry Eye

At Primary Eye Care Associates Dry Eye Center of Excellence, our initial goal is to provide you maximum relief from your dry eye symptoms. After careful analysis of the way your tears evaporate off of your eye, our doctors will initiate a treatment regimen that puts you on the path of relief from dry scratchy red irritated eyes-FOREVER.  Once your dry eye symptoms begin to improve is then time to roll up our sleeves and work with you to discover the cause of the underlying disease.  This is because dry eye is chronic.  It isn't going away by itself and may be progressive getting worse over time. 

What Is Dry Eye?

Dry eye, is a multi-factorial disease of the tears and ocular surface  which means there are "many reasons" that results in symptoms of discomfort visual disturbance and tear film instability that could damage to the front surface of your eye permanently.  Some cases of Dry Eyes make your eyes water too much (the eyes telling the body "hey we're dry!!") and so the body floods the eyes with excess tears that don't really help.  Also swelling  of the front part of the eye are some of the most common and likely causes will be investigated first.  Interestingly enough, these culprits may already be causing inflammation in other parts of your body such as arthritis and fibromyalgia odds flashes night sweats whole body temperature digestive problems and more something set may be evaluated by our doctors.

Who Gets Dry Eye?

  • hormone imbalance especially common in females and more common and menopause
  •  thyroid under or overactive thyroid gland function
  • lifestyle issues that diet hydration rest and smoking can all be contributing factors
  • stress being overstressed and exhaustion ability to produce tears or reduce inflammation the ultimate goal of your therapy.  It is to provide sustained relief from dry eye symptoms by getting to the root of the problem
  • contact lens wearers
  • post laser eye surgery and cataract patients

Meibomian Gland Dysfunction

"Ever Wonder Why Eye Drops that one doctor after the next keep giving you and they just don't work?"

MGD: Meibominan Gland Dysfunction is a very common condition where the tiny glands between your eyelashes are all clogged and jammed up with a cheesy hardened buttery substance of exfoliated skin, protein and mucous.  The gland is still functioning (for now) but cannot release the fine olive-oil like substance that is suppose to coat your eyelashes and your natural tears.

Remember OIL floats on WATER and this "Meibomian" gland is suppose to coat your tears so they don't evaporate off your eye too fast.  If your tears evaporate off your eyes too fast, you will get a burning sensation, or a trashy feeling in the eye like an eye lash, or dust particle is constantly stuck in your eye.  Sometimes, because of the Burning, your eyes will water up.  This is called refex tearing wear too much tears come into the eye and can become annoying.

In rare cases, if left all plugged up, the gland will eventually "notch" and die.  This leads to very complicated cases of dry eye syndrome.  It is always best to have this checked, and follow proper and routine hygiene that our doctors will prescribe after performing a tear film analysis on your eyes.


Another reason lubrication eye drops you buy may not work: "soponification" a foamy frothy like tear film.  This is due to the dysfunction of those tiny glands mentioned above, because they may be clogged up or they are producing a more soapy or ester like (chemical imbalance) like oil layer. 

Adding artificial tears or even prescription artificial tears may just make a "toxic soup" of tears as I like to call it...this just makes things worse.  Patients can become very frustrated and disappointed with all the money and time spent on these "miracle eye drops".  The truth is, most of the eye drops and prescription strength eye drops are actually very good, but there is a time to prescribe them.  And that time is after we've come to root of the patient's dry eye symptoms.

 Are annoying Eye Drops The only Answer?

Eye Drops May work, but they must be prescribed only after careful analysis of how your tears evaporate off your eyes.  Fluouescein testing (a yellow dye, like in the photo describing MGD above) is put into the eye and a blue cobalt light is used to see how long it takes for your tears to evaporate and too see if there is a frail tear film.  A second dye, Lysamine Green is used to determine if there are any dead cells from dryness on the white part and on the clear part of the eye.  Sometimes another dye is used called Rosebangel (ouch..this one stings, and I don't use it too much in the clinic).  We also must check for soponification and or MGD as mentioned above.

Dry Eye Treatment

  • Preservative Free Eye Lubricants, ointments and gels
  • Lacrisert (a time released "pellet" you put into your eye daily...like a contact lens, only not as big)
  • Tears Again Lypozyme Spray (for dry heavy feeling itching eye lid/lashes) (it also helps with fine wrinkles around the eye :-)  )
  • Tear Savers (tiny "plugs" made of protein we insert into that little hole you have in the corner of your lower eye lid - you have another 'hole' in your upper lid right above the lower one!-this allows tears to stay in the eye, kind of like putting the stopper in the kitchen sink)
  • Restasis: a prescription strength tear builder.  Great to build tears and restore tears...but should only be RX'd after careful dry eye severity analysis and may take 4-5 months to build your tears.
  • Heat packs ("melt that hardened butter in the glands") certain goggles at night can be worn to soothe the eyes and hyrate the eyes.
  • Omega3 fatty acids, a good pharmaceutical grade vitamin like OmegaMax is a great way to reduce inflammation and get rid of "sopinification" and your other doctors will love you for being on it! it helps with too many other things to list here in this blog!

Cost of Treating Dry Eye

Dry Eye Syndrome is a chronic condition, and needs to be monitored properly.  In our clinic we see our dry eye patients typically about 3-4 times a year.  Vitamins, goggles, sprays and over the counter lubricants may not be covered by your health insurance plans, but you can use your flex spending accounts for these items.  Generally your office visits are billed and or covered by your major medical carrier.

Stop by Primary Eye Care Associates serving the southside, Hinsdale areas, Bridgeview and surrounding areas for a free dry eye severity analysis with your truly.  Also visit www.visionbydrchander.com/dry_eye.pdf for a recent article published about our Dry Eye Center of Excellence.

Enjoy your day!

Dr. Chander :-)

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Dr. Steven Chander

Primary Eye Care Associates

Primary Eye Care Associates is a family-friendly vision care practice in Chicago. Led by our eye doctor, Dr. Steven Chander, our practice provides a variety of services, features a state-of-the-art optical laboratory, and includes an optical boutique with designer frames. Dr. Chander is certified by:

  • The National Board of Examiners in Optometry
  • The American Optometric Association

To schedule an appointment with our team, please fill out our online form or call (773) 735-6090.

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