NV Eye Surgery — Dry Eye Treatment
You Live in
a Desert. Your Eyes Know It.
In a dry climate like Las Vegas, many people develop symptoms of dry eye or blepharitis. Both are usually chronic, and the goal of treatment is keeping your eyes comfortable with as little daily effort as possible.
- Testing that identifies which type of dry eye you actually have
- A stepwise plan starting simple and escalating only as needed
- LipiFlow, IPL, and punctal plug procedures available in office
Is This Right for You?
Am I a Candidate for Dry Eye Treatment?
Symptoms vary widely, and most patients experience a combination rather than all of them. Several are counterintuitive enough that patients do not connect them to dryness.
A watering eye is often a dry eye. Anything irritating the eye triggers reflex tear production, the same mechanism that floods your eye when dust gets in. Those reflex tears are watered down and do not relieve the underlying dryness, so you get cycles of dryness followed by excess tearing. The same logic applies to blurry vision that comes and goes: clear sight needs a smooth tear layer, and dry spots break up incoming light.
The Procedure
What Is Dry Eye?
The eye needs to stay moist to feel comfortable and see clearly. Tears are made by the lacrimal gland under the upper eyelid, and drain through small openings near where the eyelids meet, which is why crying produces a runny nose. Healthy tears have three thin layers: a mucin layer that helps the water stick to the eye, a water layer carrying nutrients and enzymes, and an oil layer from the meibomian glands in the eyelids that stops the water from evaporating. Dry eye develops when the gland underproduces, when tears evaporate too quickly, which is very common here, or when tear quality is simply poor. Most patients have more than one of these at once.
Blepharitis
Diagnosed when your doctor sees a buildup of oily or flaky skin at the eyelid edges, often with redness, clogged oil glands, and an overgrowth of bacteria around the lashes.
Aqueous Deficiency
The tear gland does not produce enough fluid, which is addressed with tears, gels, Lacrisert, Restasis, punctal plugs or cautery, hydration, and a humidifier.
Oil Deficiency
The oil layer is inadequate, treated with warm compresses, lid hygiene, nutritional supplements, antibiotics, manual gland expression, LipiFlow, and IPL.
Unhealthy Tears
Normal watery fluid with a decreased oil coating, leading to fast evaporation, tired eyes, and burning irritation even though the eye appears moist.
Patient Reviews
Treatment Options
Home Care, Prescriptions, or Procedures?
Dry eye and blepharitis overlap heavily, and most patients have both to some degree. Treatment climbs a staircase: simple measures first, then prescriptions, then in-office procedures. The right step depends on how severe your symptoms are and how much daily effort you can realistically sustain.
Home and Over-the-Counter
Artificial tears, compresses, and lid hygiene
- Immediate improvement should be noticeable when lubricating drops go in
- Mild symptoms may need drops only two or three times a day
- Warm compresses soften blocked oil so it can be expressed
- A bedroom humidifier and adequate hydration both help measurably
- Severe symptoms may need drops every two to three hours
- Preservatives can irritate the eye if drops are used more than four times daily
- Moisture goggles keep the air around the eye humid and block wind, and are especially helpful for severe dry eye
Start Here
Prescription Therapy
Restasis, steroids, Lacrisert, oral antibiotics
- Restasis actually increases tear production by controlling inflammation
- Benefit continues increasing for up to a year after starting
- Steroid drops bring symptoms under control while Restasis takes hold
- Oral antibiotics help severe blepharitis through some non-antibacterial action
- Restasis takes six to eight weeks for initial effect and needs consistent use
- Overuse of steroid drops can cause premature cataracts and glaucoma
When Drops Fall Short
In-Office Procedures
Punctal plugs, LipiFlow, IPL, cautery
- Punctal plugs are a painless five-minute procedure, recommended for all patients with dry eye symptoms
- A good option if a busy schedule makes regular drops unrealistic
- LipiFlow has been shown more helpful than warm compresses alone
- A single LipiFlow treatment may remain effective for up to a year
- LipiFlow is expensive, and manual expression is the lower-cost alternative
Least Daily Effort
Determining the cause comes before choosing the treatment. Fluid deficiency and oil deficiency call for different approaches, and testing is what tells them apart.
Step by Step
Your Dry Eye Treatment Journey
Dry eye treatment is deliberately stepwise. It starts with the simplest measures and escalates only when those are not enough.
1
Examination and Testing
- Eyes and tears examined under a microscope
- Lashes checked for debris or infection, oil glands for output
- Schirmer test measures fluid produced each minute
- Tear osmolarity checks whether too much water has evaporated
- LipiView measures oil layer thickness, gland quality, and blink pattern
2
Starting Simple
- Artificial tears, with Retaine, Systane, or Refresh for moderate cases
- Preservative-free vials if you need drops more than four times daily
- Gel or ointment at bedtime, since both temporarily blur vision
- Warm compress or mask, microwaved 25 to 30 seconds, five minutes at a time
- Lid hygiene nightly with towelettes, cleansing foam, or baby shampoo
3
Adding Prescription Therapy
- Restasis twice daily, controlling inflammation to increase tear production
- Steroid drops briefly, to bring symptoms under control while Restasis starts working
- Lacrisert, a daily pellet that dissolves into a thick gel
- Oral antibiotics for severe blepharitis: doxycycline, tetracycline, or minocycline
- Omega-3 supplements, either fish oil or flaxseed
4
In-Office Procedures
- Punctal plugs, a painless five-minute office procedure blocking the tear drain
- Punctal cautery if plugs irritate the eye or fall out
- Manual expression of the meibomian glands
- LipiFlow, where a single treatment may be effective for up to a year
- Intense pulsed light near the eyelids to improve oil gland output
What to Expect
Expected Dry Eye Treatment Outcomes & Recovery
Dry eye and blepharitis can be frustrating conditions, but they can almost always be controlled with a combination of the therapies available. Most are chronic, so treatment continues long term.
What Patients Can Expect in the First 30 Days
- Close your eyes for a few minutes after each drop to help it absorb
- Preservative-free vials must be used within 24 hours of opening
- Apply gel and ointment at bedtime, since both blur vision temporarily
- Microwave the compress mask 25 to 30 seconds, then five minutes on the eyes, and repeat
- Expect mild redness and stinging for a week or two after starting Restasis
- Wear sunscreen if you are taking doxycycline, which causes sun sensitivity
Informed Care
Safety & Risk Considerations
Dry eye treatments are largely low-risk, and the office procedures are quick and painless. A few of the medications do carry real cautions worth knowing about before you start.
Safety Profile
- Punctal plug placement is a painless five-minute office procedure
- Tear osmolarity testing can also monitor whether treatments are working
- Restasis is a very dilute solution of cyclosporine and is used twice daily alongside other treatments
- Severe dry eye leading to corneal scarring and permanently blurred vision is quite rare, with many treatment options available along the way
- Patients with dry eye should have a good eye exam at least once or twice a year
Possible Side Effects
- Preservatives in artificial tears can irritate the eye when drops are used more than four times daily
- Gel and ointment forms temporarily blur vision when applied, which is why they are typically used at bedtime
- Restasis can cause mild redness and stinging for a week or two after starting
- Overuse of steroid drops can lead to premature cataracts and glaucoma, so they are used intermittently for a few weeks at a time
- Doxycycline can cause stomach upset and sun sensitivity, and interacts with blood thinners and other medications
How We Minimize Risk
Testing Before Treating
The different causes of dry eye and blepharitis require different approaches, so determining the cause is the first step. Schirmer, tear osmolarity, and LipiView testing separate fluid deficiency from oil deficiency.
Escalating Only as Needed
Treatment follows a stair-step approach starting with very simple steps and working up. That keeps you on the least burdensome therapy that actually controls your symptoms.
Refractive Surgery Screened Against Dry Eye
LASIK cuts corneal nerves and worsens dry eye, so we do not perform it on patients whose symptoms are not well controlled. ICL or PRK are the better options for those eyes.
Why NV EYE SURGERY
Why Treat Dry Eye Here
Our dry eye center has the technology to identify which type of dry eye you have, which is the step that determines whether treatment works.
Diagnosis Before Treatment
Schirmer testing, tear osmolarity, and LipiView tear evaluation separate fluid deficiency from oil deficiency. Fluid deficiency and oil deficiency call for different treatments, so testing comes first.
The Full Treatment Ladder
From artificial tears through punctal plugs, LipiFlow, and IPL, the whole range is available here, so escalation does not mean a referral elsewhere.
A Patient Who Understands It
Our doctors believe a well-informed patient is a better team member in treating a chronic condition, so we take time to explain your diagnosis and your options.
Our Team
Meet Our Dry Eye Team
Dry eye and blepharitis are managed by our doctors as a chronic condition rather than a single visit, with diagnostic testing and treatment escalation handled collaboratively across our Henderson and Northwest Las Vegas offices.
Find Us
Dry Eye Treatment in Henderson & Las Vegas
Dry eye testing and treatment at both offices, including in-office procedures.
Coverage & Financing
Cost & Insurance
Dry eye is a medical condition, so office visits fall under your medical insurance. A couple of specific items sit outside coverage and we say so upfront.
Insurance Coverage
Office visits for eye problems are covered under medical insurance rather than a vision plan. Your plan determines your co-pay and deductible.
- Common plans accepted include Medicare, Blue Cross Blue Shield, Cigna, Aetna, Culinary, UMR, Teachers, United HealthCare, Sierra Health and Life, and TriCare
- LipiView tear evaluation is typically not covered by insurance, though it is a key test for identifying causes
- Our office is not a provider on vision insurance plans and does not do exams for glasses or contact lenses
- Text a photo of your insurance card to (702) 935-5746 and our staff will confirm your coverage
- We take Medicare but cannot see Senior Dimensions or Humana Gold Medicare Advantage patients except in rare authorized cases
Out-of-Pocket Items
Some dry eye treatments are purchased rather than billed, and a few of the procedures carry costs your plan may not cover.
- Artificial tears, lid towelettes, cleansing foam, and compress masks are available in our office and at most pharmacies
- A premium omega-3 fish oil capsule is stocked here, with other options at any grocery store
- LipiFlow is expensive, while manual expression is a lower-cost alternative with slightly more discomfort
- You can be seen even without medical insurance, and we have many payment options
Flexible financing available. We work with CareCredit to offer low- and no-interest payment plans for care not covered by insurance. Ask about your options at your visit. Results may vary. Individual results are not guaranteed. Financing subject to credit approval. See office for complete terms and conditions.
locationsCommon Questions
Frequently Asked Questions
The dry eye questions patients ask most, including several where the symptom seems to contradict the diagnosis.
What causes dry eye?
Most patients have more than one cause. Common ones include dry air, age, blocked eyelid oil glands, decreased blinking during reading or computer use, blepharitis, contact lens wear, prior LASIK, eye allergies, and overuse of drops with preservatives. Conditions such as lupus, rheumatoid arthritis, Sjögren’s disease, diabetes, and rosacea can contribute, as can certain medications and hormonal changes. Eyelids that don’t close fully, including from Bell’s palsy or loose eyelids, can also dry out the eye.
Why do my eyes water if they are dry?
Anything that irritates the eye triggers reflex tear production, the same way your eye floods when dust gets in. Those reflex tears are watered down and do not stop the underlying dryness, so you cycle between dry stretches and excess tearing. It is one of the most common dry eye patterns.
Why does dry eye blur my vision?
Clear vision needs a smooth corneal surface covered by a thin tear layer. When that layer is unhealthy, small dry spots break up incoming light and create foggy or hazy vision. If your vision fogs after 30 to 40 minutes of reading, keep artificial tears nearby and use them every 15 minutes while you read.
Why does it hurt?
The cornea has more nerves than any other tissue in the body, and they sense pain when irritated. When tears are not lubricating properly those nerves fire, which registers as burning, stinging, foreign body sensation, or tired eyes. It is a feedback system the eye uses to protect itself.
Is dry eye dangerous?
Rarely, but not never. Without a healthy layer of moisture the normally clear cornea can develop scar tissue and start to cloud, which in very severe cases leads to permanently blurred vision. That is uncommon, and there are many treatment options along the way. Patients with dry eye should be examined once or twice a year.
What are punctal plugs?
Small flexible silicone plugs that sit inside the tear drain in your eyelid and block tears from leaving the eye surface, the way a stopper fills a bathtub. Placement is a painless five-minute office procedure, and we recommend it for all patients with dry eye symptoms.
Can I still have LASIK if I have dry eye?
You should not have LASIK if your dry eye symptoms are not well controlled. Healthy corneal nerves signal the body to produce more tears, and LASIK cuts those nerves, which blocks the feedback loop. ICL or PRK are the better options, and both are performed here.
Why am I developing dry eye now?
Changes in systemic medications, environment, eating habits, stress, age, eye surgery, and illness all affect healthy tear production. Symptoms can appear at any time. Antihistamines, decongestants, diuretics, hormone replacement therapy, certain antidepressants, and isotretinoin-type acne drugs are all common culprits.
What is Demodex?
A small mite that lives in the hair follicles around eyelashes and eyebrows. Nearly every adult has a few with no symptoms. Some patients have an increased population or an allergic reaction, producing red crusty lids, itching, burning, and blurred vision. This type does not respond to typical treatment and may need repeated tea tree oil application.
Ready When You Are
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Most patients see results within 24 hours. Consultations are available at all four locations, online scheduling takes less than two minutes.
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