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Many people, whether they are aware of it or not, suffer from dry eyes. Dry eye syndrome (DES) is one of the most common yet most under diagnosed conditions affecting the health of the eye. We are learning now that the complex nature of dry eye can begin as young as 10 or 11 years old and continues throughout a patient’s life.

The symptoms of dry eye syndrome vary, however, some of the most common symptoms are:

  • Dryness
  • Redness
  • Scratchiness
  • Blurred vision
  • Foreign body sensation
  • Burning sensation
  • Sandy/gritty sensation

Types of Dry Eye Syndrome

Tears are comprised of 3 layers: lipid (oil), water, and mucus. The composition of these components is what helps to protect and nourish the surface of our eyes. The lipid or oil layer prevents the evaporation of the water layer. The mucus layer helps spread the tears evenly over the eye surface. When these layers are not functioning properly, the tears can either evaporate too rapidly or they do not reach the entire eye surface, which will then cause the symptoms of dry eyes.

There are 2 predominant forms of dry eye:

Aqueous Dry Eye

Aqueous dry eye is characterized by tear deficiency. It occurs when the lacrimal glands don’t produce enough of the watery component of tears.

Evaporative Dry Eye

Evaporative dry eye affects 65% of dry eye patients. It is caused by Meibomian gland dysfunction (MGD), which creates a deficiency in the oil layer of the tear film. These glands make the lipid or oily part of tears that slows evaporation and keeps the tears stable. This can be the beginning of other dry eye disease problems including damage to the cornea and sight-related issues.

Diagnosing Dry Eyes

Because dry eye symptoms can be very subtle, patients can go undiagnosed or under treated. At Advanced Eye Care, we utilize a multi-faceted approach to diagnosing dry eye syndrome. We combine patient self-assessment, physician administered testing, and state-of-the art diagnostic technology to determine the cause, severity, and best treatment protocol for each patient’s dry eye condition. Your diagnostic process may include:

  • SPEED™ Dry Eye Questionnaire
  • Osmolarity testing (TearLab)
  • Inflammation Testing (InflammaDry)
  • Lipid layer testing (LipiView)
  • Blinking pattern evaluation (LipiView)
  • Allergy testing if allergies are suspected
  • Testing for Sjogren’s syndrome, if indicated

Our Approach to Treatment for Dry Eyes

Like other chronic conditions such as high blood pressure and diabetes, dry eye may affect you long before you experience noticeable symptoms. It’s important to detect and diagnose dry eye early so that we can start managing your condition, preserving your eye health and vision.

As a Dry Eye Center of Excellence, Advanced Eye Care stays at the forefront of research and technology for the management of dry eye. Our doctors pursue continued training and education so that we can offer the best care to our patients. Treatment is customized and often multi-faceted, incorporating various clinical therapies as well as at-home care.


The simplest and most common treatment for dry eye is the use of artificial tears or lubricating agents to supplement your own natural tear production.  We make very specific recommendations of artificial tears based on the results of your dry eye tests, and we offer all of the best products at our office.


Chronic inflammation is a common cause of dry eye, especially in middle-aged women. Restasis is a highly effective drop that treats the inflammation and helps increase your eyes’ natural ability to produce tears. It is a key component in the treatment of dry eyes, and early treatment can help you get better control of your dry eyes. Restasis has an excellent safety profile, and can be used over very long periods of time.

The standard of medical care for dry eyes is Restasis, often in combination with Lotemax and Azasite drops for the treatment of acute inflammation, or an acute worsening of chronic inflammation. Lotemax gel is a very effective steroid drop that has the best safety profile of all topical steroids. Azasite is a drop used to treat eyelid margin disease. This drop can be used for infections of the eyelids and also to help the oil glands on the eyelids to function properly.


This unique system combines visual imaging to diagnose a patient’s dry eye syndrome with a treatment which applies painless heat and compression to unclog the Meibomian glands.

LipiView is the digital imaging component that allows your ophthalmologist to measure the lipid layer of your tear film. Until the development of LipiView, ophthalmologists did not have a way to visually show that patients were lipid deficient.

The LipiView only takes a few minutes to evaluate your eyes. You will simply look into a camera and blink normally. A special light, camera and computer program do everything else. Then your doctor will be able to determine the best therapy.

If you are diagnosed with dry eye syndrome secondary to Meibomian gland dysfunction, you can then undergo a 12 minute LipiFlow treatment. This uses a single-use eyepiece to relieve blockage of all the Meibomian glands, both upper and lower. The treatment sensation has been compared to an eyelid twitch or gentle pulsation.

After a treatment, the glands become unclogged and in 2 to 6 weeks you should see a noticeable difference in your dry eye symptoms. This is because the natural production of lipids needed for your tear film resumes functioning normally.


PROKERA is a biologic corneal bandage which has natural therapeutic actions known to heal the eye faster with less pain, scarring and inflammation. It actually promotes healing in our Chronic Dry Eye patients, as well as others with corneal diseases or injuries. It is easily inserted and removed at our office and sometimes can be used on one or both eyes multiple times depending on our patient’s needs.

Other Remedies for Dry Eye

At Advanced Eye Care in Bel Air,  we offer an array of all the top at-home products for the management of your dry eye, including eyelid cleanser, a nutriceutical line, and medical grade lubricants. Additionally, you can improve your comfort and eye health by implementing these practices:

  • Use a humidifier
  • Wear protective glasses
  • Stay well-hydrated

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