Dry Eyes

Why are my eyes so DRY?
There are many different reasons for Dry Eye Disease. Some people have a combination of different causes. The basic categories include:
1. Inflammatory Dry Eye Disease;
2. Evaporative Dry Eye Disease;
3. Infestation Dry Eye Disease.

Inflammatory Dry Eye Disease
With Inflammatory Dry Eye Disease, the production of the water component of tears is abnormally low. Some prescription eye drops, like Restasis, combined with artificial tears, may successfully treat this condition. In addition, punctual plugs may be helpful in keeping your natural tears from draining out of the eyes too quickly.

Evaporative Dry Eye Disease
If your eyes make enough tears, but they evaporate too quickly, this is generally because of a problem with the oil layer of the tears. This occurs because the Meibomian oil glands at the edge of the eyelids are not functioning properly. They may be clogged with congealed, toxic oil, and they may eventually sustain permanent damage. This is called Meibomian Gland Dysfunction (MGD). This condition can lead to permanently disfiguring notches in the edges of the lids, chronic overpopulation of Demodex mites, chronic and serious Dry Eye Disease, and in some cases permanent damage to the eyes and loss of clear vision.

Infestation Dry Eye Disease
It is normal to have a few Demodex mites living in the eyelash follicles beneath the surface of the skin. However, an infestation of these tiny Demodex mites is not normal and can lead to chronic and serious Dry Eye Disease. It is not proven why Demodex mite infestation is on the rise, but it appears that Demodex mites thrive in eyes that also have MGD. Itching along the lash line, yellow or sticky deposits on the base of the lashes, and dry, burning eyes are all symptoms relating to Demodex mite infestation.

What can I do about Dry Eye Disease?
Because there are many different causes, the same treatments don’t work well for all of the types of Dry Eye Disease. Here are some steps you can take at home before coming for an in-office evaluation:
• forceful blinking for a few seconds, several times per hour
• heat mask application for 5-10 minutes per night
• gently scrubbing along the base of the lashes every day
• artificial tears containing mineral oil (Systane Balance or Retaine)
• AVOID any eye drops that are Redness-Reducing
There are commercially available microwaveable heat masks and lid scrubs made just for use around the eyelashes and eyelids. For eyelid scrubbing, do not use anything on or near your eyes at home that is not specifically formulated for that use. Read the labels carefully.

What if eye drops and my best efforts do not take care of the problem?
Some people will need more than just home efforts and eye drops. If you still have symptoms after 2 weeks of the regimen recommended above, or if you notice persistent flakes or waxy build-up at the base of your eyelashes, then you need a more detailed DRY EYE EVALUATION. If you already have a notch in your eyelid or missing eyelashes, but have no symptoms, you probably need treatment.

At your DRY EYE EVALUATION appointment, the eye doctor will perform tests that will determine an appropriate treatment protocol for you. The evaluation visits will be billed to your medical insurance (not vision insurance). Your coverage will be pre-verified before your appointment. You are responsible for payment of your insurance co-pays and any unmet deductible amounts. These evaluations are not part of the annual eye exam, and no glasses or contact lens prescriptions will be done at this type of visit. These evaluations may not be done on the same day as the annual or routine eye exam.

Inflammatory Dry Eye Disease Treatment
If the cause of your Dry Eye Disease is found to be inflammatory, then the eye doctor will give you a prescription for an eye drop that may help to reduce the inflammation and increase production of your own natural tears. In addition, the eye doctor may recommend the insertion of punctal plugs to prevent the tears you make from draining out too quickly. The procedure to insert the punctal plugs will be billed to your medical insurance (not vision insurance).

Meibomian Gland Dysfunction (MGD) In-office Treatment
If you have Evaporative Dry Eye Syndrome as a result of MGD, then the eye doctor can perform an in-office treatment that will remove the congealed, toxic material trapped inside the Meibomian oil glands. Your eyelids will be heated (please bring your own microwaveable heat mask to the appointment if you have one). Then, after a numbing eye drop is given, the doctor will use tools to extract the material from the Meibomian oil glands. The treatment procedure is slightly uncomfortable but not painful. This in-office procedure is not covered by insurance, and you are responsible for the in-office treatment fee at the time of the treatment procedure. Sometimes patients require additional in-office treatments, if the Meibomian oil glands are deeply impacted such that full extraction is not possible at the first treatment visit. Also, some patients, despite best home efforts, become clogged again several months later. Another visit approximately 1 month following initial treatment is recommended to assess whether further treatments are necessary.

Demodex Infestation In-office Treatment
If you have an overpopulation or infestation of Demodex mites, the doctor will perform a procedure to treat this condition. Your eyes will be numbed during the procedure. Most people report that the procedure is very comfortable; there is typically a rapid relief of symptoms after the infestation is treated. Remember that everyone has a few Demodex, so the goal is not to eliminate the Demodex, but rather to eliminate the overpopulation or infestation. An infestation that continues too long can damage the eyelash follicles and ultimately the eyes themselves. The entire evaluation and treatment visit, including the pre-treatment evaluation and the treatment itself, typically takes about 1 hour. This in-office procedure is not covered by insurance, and you are responsible for the in-office treatment fee at the time of the treatment procedure. It is unusual for people to require more than one in-office treatment specifically for this condition, but this may be needed if repopulation occurs.

If you would like to schedule a Dry Eye Evaluation appointment, please call the office at 713-520-6600. Have your medical insurance information handy, so that we may pre-verify any coverage you may have ahead of time. If you have a microwaveable heat mask, please bring it with you to all Dry Eye Evaluation and treatment appointments.

  • Contact

    EyeContact of Houston
    P: 713.520.6600
    E: eyecontact@eyecontact.com
    2055 Westheimer Road, Suite #135
    Houston, TX 77098


    Monday – Friday: 9a.m. to 6p.m.
    Saturday: 9a.m. to 4p.m.
    Sunday: Closed

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