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Dr. Stevens
Dr. Stevens, Ophthalmologist
Category: Eye
Satisfied Customers: 1404
Experience:  Board Certified Ophthalmologist
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I have chronic dry eye. I have tryed plugs, restasis for 6

Resolved Question:

I have chronic dry eye. I have tryed plugs, restasis for 6 months 2 times in 2 years, theralife eye enhanced, and several different eye drops to no avail. My eyes water constantly and tears run down my face nearly all day. What are my options?
Submitted: 8 years ago.
Category: Eye
Expert:  Dr. Stevens replied 8 years ago.
It is obvious you have treated the tear deficiency aspect of your dry eye very well. If you still had significant dry eye, you would not have as much tearing as you do. Lets talk about the eye a bit. You may or may not know, the tears that help lubricate the eye are made of 3 different components. One is the actual watery component made in the lacrimal gland under your brow. It is where the water is made and if you get something in your eye or your eye is irritated, this gland goes in to overdrive and causes tears to be produced excessively. Second, is the mucous component and rarely do patients have a deficiency of this (often there seems to be an abundance). Third is the oily component of the tears and this comes from the glands at the base of the lashes, called meibomian glands. Those glands are often the culprit in someone with your symptoms. If those glands drain poorly, often as a consequence of aging, sometimes associated with rosacea (cause of adult acne), the tears are unstable and the eyes become irritated and can tear.

Unfortunately, unless the glands become more functional, the situation never gets better. So the best treatment for this situation is the faithful and consistent application of heat packs which help the oils get moving. We are not talking a warm washcloth, that gets cold quickly, rather a heat pack that applies constant heat for at least 3-5 minutes at a time. If this does not provide good relief, your doc may consider an antibiotic like doxicycline, tetracycline or minocycline for 6-8 weeks or longer. These help the glands drain better. Also, use lubricant drops a few times a day, Refresh Celluvisc is a wonderful one to try. This regimen will help you make more stable tears and reduce the surface irritation and help make your eyes feel better, and in time the symptons will improve. Take care and let me know if there is any more questions or concerns.

Sincerely ***** *****

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