Dry eye disease is a complex condition associated with a wide variety of individual, environmental and disease-related factors.

It is affecting the tears and ocular surface resulting in symptoms of discomfort, visual disturbance, and tear film instability, with potential damage to the ocular surface.

The tear film of the eye consists of three layers: oil (produced by meibomian glands at the edges of the eyelids near the eyelashes), water(produced by the lacrimal glands under the eyebrow), and mucus (produced by conjunctival glands on the white of the eye). Each serves its own purpose. The disruption of the oily layer will cause Evaporative Dry Eye Disease, which is the most common type. The disruption of the watery layer would cause Aqueous deficiency and Dry Eye Disease. When patients don’t produce enough tears in one of two layers it can become very symptomatic and debilitating.


Common symptoms of Dry Eye Disease are itching, redness, burning, tearing, blurry vision, ocular fatigue, and even headaches. Some patients mention foreign body sensations and some say they cannot keep their eyes open for very long. People who work long hours at a computer blink much less than should, which causes disruption of the tear film and quicker tear evaporation. All these symptoms may be very painful and debilitating in our daily lives.


There are multiple factors that affect tear production. Older age( women affected more than men), smoking, contact lens wear, environmental irritants such as dry air, smoke, air conditioning, heating all contribute to worsening Dry Eye Disease. Some autoimmune diseases such as Lupus and Rheumatoid arthritis affect tear secretion that leads to inflammatory Dry Eye Disease. Diseases such as Diabetes and Herpes Zoster are associated with decreased corneal sensation that causes to produce less tears.  A skin condition such as Rosacea is a common one to affect eyelids and production of the oily part of the tear film. A wide variety of common medications, both prescription and over-the-counter, can cause dry eye by reducing tear production.

Some medication that we pay close attention to are:

  • High blood pressure (Lasix, hydrochlorothiazide, Atenolol, Propranolol, Bystolic)
  • Antihistamines for allergies (Benadryl, Claritin, Zyrtec, Allerga)
  • Anti-anxiety and anti-depression medications (Zoloft, Prozac, Celexa)
  • Acne medication (isotretinoin)
  • Pain relievers (Ibuprofen)
  • Chemotherapy Medication (Cytoxan)
  • Birth Control


First and the most important step in treating Dry Eye Disease is to evaluate and diagnose what type and at what level of severity Dry Eye Disease is presented and based on the condition Dr. Tanya Mikitchenko may initiate one or multiple treatments such as:

  • Artificial tears- lubricating eye drops that help moisturize the surface.
  • Lubricating gel or ointment- provide extra lubrication for the ocular surface during sleep.
  • Humidifier or pan of water on the radiator can add additional moisture to dry air.
  • Omega-3 fatty acids- may provide relief by allowing the oil glands to produce better oils for extra moisturization.
  • Prescription medication such as Restasis, Xiidra or Cequa can be prescribed for dry eye management to improve the Aqueous layer of the tear film.
  • Punctal Plugs - help to retain your own tears on the surface of your eyes.
  • IPL- Intense Pulsed Light can help to warm up and express clogged glands that cause Evaporative Dry Eye Disease.