AFFILIATED EYE SURGEONS | DRY EYE CARE
Dry Eye Treatment in Northern New Jersey
Chronic dry eye is more than an inconvenience — it is a real medical condition that deserves real treatment. Our
board-certified ophthalmologists diagnose the underlying cause of your dry eye and build a targeted treatment plan to give you lasting relief.
More Than Just Eye Drops
Dry eye disease affects an estimated 16 million Americans and is one of the most common reasons people visit an eye doctor. Yet it remains one of the most undertreated conditions in eye care — largely because many patients (and even some providers) treat it as a minor inconvenience managed with over-the-counter drops rather than a genuine medical condition with identifiable causes and targeted treatments.
At Affiliated Eye Surgeons, we take dry eye seriously. Our approach begins with a thorough diagnostic evaluation to understand the underlying cause of your symptoms — whether that is meibomian gland dysfunction, aqueous tear deficiency, ocular surface inflammation, or a combination. From there, we build a personalized treatment plan that addresses the root cause rather than just masking symptoms.
Whether you have mild, occasional dryness or severe, vision-affecting dry eye disease that has failed multiple prior treatments,
our team has the diagnostic tools and treatment options to help.
What Is Dry Eye Disease?
Dry eye disease (also called keratoconjunctivitis sicca or dry eye syndrome) is a chronic condition in which the eye fails to maintain a stable, healthy tear film. The tear film is a thin, three-layered coating that covers the eye's surface — composed of an inner mucin layer, a middle aqueous (water) layer, and an outer oily (lipid) layer. When any of these layers is deficient or unstable, the tear film breaks down, the ocular surface becomes exposed and inflamed, and dry eye symptoms result.
There are two primary types of dry eye disease, and many patients have a combination of both:
- Aqueous-deficient dry eye — the lacrimal glands do not produce enough of the watery middle tear layer. This is less common and often associated with autoimmune conditions such as Sjogren's syndrome.
- Evaporative dry eye — the most common type, occurring when the meibomian glands in the eyelids do not produce sufficient oil for the tear film's outer layer. Without adequate oil, tears evaporate too rapidly even when production is normal. This is also called meibomian gland dysfunction (MGD).
Common symptoms of dry eye disease include:
- Persistent dryness, burning, or stinging sensation
- Gritty or foreign-body feeling — as if something is in the eye
- Light sensitivity (photophobia)
- Blurred or fluctuating vision, especially after prolonged reading or screen time
- Eye redness and irritation
- Excessive tearing or watery eyes — a paradoxical reflex response to dryness
- Eye fatigue and difficulty sustaining focus
- Contact lens discomfort or intolerance
What Causes Dry Eye?
Dry eye disease has many causes, and identifying the right one for each patient is the foundation of effective treatment. The most common causes and contributing factors include:
Meibomian Gland Dysfunction (MGD)
The most prevalent cause, present in up to 86% of dry eye patients. The meibomian glands along the eyelid margins become blocked or atrophied, reducing the oily tear layer that prevents evaporation.
Aging
Tear production naturally decreases with age. Dry eye is significantly more common in adults over 50.
Hormonal Changes
Particularly in women during menopause, pregnancy, or while taking oral contraceptives. Hormonal fluctuations affect both tear quantity and quality.
Digital Screen Use
Reduced blink rate during screen time leads to faster tear evaporation and ocular surface drying. Extended computer, phone, or tablet use is a major modern contributor.
Contact Lens Wear
Soft contact lenses can disrupt the tear film and trigger or worsen dry eye.
Medications
Many common medications reduce tear production as a side effect, including antihistamines, decongestants, antidepressants, blood pressure medications (beta-blockers, diuretics), and acne treatments (isotretinoin).
Autoimmune Conditions
Sjogren's syndrome, rheumatoid arthritis, lupus, and other autoimmune disorders can directly damage the tear-producing glands.
Prior Eye Surgery
LASIK and other refractive surgeries temporarily or permanently reduce corneal sensation, reducing the reflex that triggers blinking and baseline tear production. Dry eye is a common post-LASIK complaint.
Environmental Factors
Low humidity, air conditioning, wind, and smoke accelerate tear evaporation and worsen symptoms.
How We Diagnose Dry Eye
A proper dry eye evaluation goes well beyond asking about symptoms. At
Affiliated Eye Surgeons, we use a comprehensive assessment to identify the type and severity of your dry eye and pinpoint the underlying cause.
- Symptom questionnaires — standardized validated tools (such as the OSDI or DEQ-5) quantify the type and severity of your symptoms and provide a baseline for tracking treatment response.
- Tear break-up time (TBUT) — a dye is instilled in the eye and the examiner measures how quickly the tear film breaks apart after a blink. Short break-up time indicates tear film instability.
- Meibography — specialized infrared imaging of the meibomian glands within the eyelids reveals the degree of gland atrophy and dropout, helping stage the severity of MGD.
- Schirmer test — a small strip of filter paper placed at the lid margin measures aqueous tear production over 5 minutes.
- Corneal and conjunctival staining — dye stains identify areas of damaged or desiccated ocular surface cells.
- Tear osmolarity testing — measures the salt concentration of the tears, which is elevated in dry eye disease and serves as an objective biomarker.
- Lid margin and eyelash evaluation — assesses for blepharitis, demodex mite infestation, and other eyelid conditions that contribute to dry eye.
Dry Eye Treatment Options
Treatment is always tailored to the underlying cause, severity, and your lifestyle. Here is the full range of options we offer at
Affiliated Eye Surgeons — from foundational therapies to advanced
in-office treatments:
Step 1: Foundational Treatments
Step 2: Prescription Treatments
Step 3: Advanced In-Office Treatments
Step 4: Scleral Lenses for Severe Dry Eye
For mild dry eye or as the foundation of any treatment plan:
- Preservative-free artificial tears — high-quality lubricating drops used consistently throughout the day to supplement the tear film. Preservative-free formulations are essential for frequent use to avoid preservative toxicity to the ocular surface.
- Warm compress therapy — applying a warm, moist compress to closed eyelids for 5 to 10 minutes daily softens congested meibomian gland secretions. Specially designed heated masks (such as the Bruder mask) are more effective than a standard washcloth.
- Omega-3 fatty acid supplementation — high-quality omega-3 supplements support meibomian gland health and tear film lipid layer quality. Multiple clinical studies support their use as a systemic dry eye treatment.
- Blink exercises and screen breaks — the 20-20-20 rule (every 20 minutes, look 20 feet away for 20 seconds) and deliberate blinking exercises reduce screen-related dry eye symptoms.
- Environmental modifications — humidifiers, positioning screens below eye level, and avoiding direct air conditioning or fan flow toward the eyes reduce evaporative stress.
For moderate dry eye or when foundational treatments alone are insufficient:
- Prescription anti-inflammatory drops — cyclosporine A (Restasis, Cequa) and lifitegrast (Xiidra) reduce chronic ocular surface inflammation that drives tear gland dysfunction. These require consistent use for 3 to 6 months for full effect and are often the cornerstone of moderate-to-severe dry eye management.
- Punctal plugs — tiny silicone plugs inserted painlessly into the tear drainage ducts at the inner corner of the eyelids. By blocking drainage, they retain the tears the eyes do produce on the ocular surface for longer. Plugs are particularly effective for aqueous-deficient dry eye.
- Lid hygiene and demodex treatment — prescription lid scrubs, hypochlorous acid sprays, or demodex-targeted treatments (such as tea tree oil-based products) address eyelid margin inflammation that contributes to MGD and dry eye.
For moderate-to-severe dry eye, particularly meibomian gland dysfunction that has not responded adequately to the above:
- TearCare® — an advanced in-office treatment that gently warms and clears blocked meibomian glands to restore healthy tear production and provide lasting relief from dry eye symptoms
- Meibomian gland expression — in-office manual or device-assisted expression of the meibomian glands unblocks clogged gland openings and restores oil flow to the tear film.
- TempSure Envi radiofrequency — radiofrequency energy applied around the eyelids produces deep tissue warming that melts stagnant meibomian secretions and stimulates collagen remodeling in the gland tissue.
- Amniotic membrane treatment — for patients with severe ocular surface disease, amniotic membrane (Prokera or similar) can be temporarily placed on the eye to reduce inflammation and promote healing of the corneal and conjunctival surface.
For patients with severe dry eye ocular surface disease that cannot be adequately controlled with drops or in-office treatments — particularly those with Sjogren's syndrome, Stevens-Johnson syndrome, chemical burns, or graft-versus-host disease — scleral contact lenses offer a therapeutic option that no other treatment can replicate.
Scleral lenses vault over the entire corneal surface and maintain a continuous reservoir of preservative-free saline in contact with the eye throughout wear. This provides constant ocular surface hydration, protection from the environment, and relief from the friction and exposure that drives severe dry eye pain. For some patients, scleral lenses are life-changing.
Why Choose Affiliated Eye Surgeons for Dry Eye Care?
Diagnosis First — Not Just Drops
Our dry eye evaluation identifies what type of dry eye you have and what is causing it — before recommending treatment. This evidence-based approach means you receive treatments matched to your actual condition, not a generic protocol applied to everyone who walks in with dry eye complaints.
Full Spectrum of Treatment Options
From preservative-free artificial tears through prescription anti-inflammatory drops, punctal plugs, IPL therapy, and
scleral lenses, we offer the complete range of dry eye treatments under one roof. Patients do not need referrals to multiple specialists — we coordinate your entire dry eye care plan in one practice.
Dry eye is a medical condition, not just a comfort issue. Having board-certified ophthalmologists manage your dry eye care means that any associated conditions — corneal staining, surface damage, meibomian gland atrophy — are identified and addressed as part of your overall eye health, not in isolation.
Connection to Specialty Contact Lens Expertise
For patients whose dry eye is complicated by
keratoconus or other corneal conditions — or who need scleral lenses as part of their dry eye management — our team's expertise in
specialty contact lens fitting is directly available. This integration is rare and valuable.
Three Convenient Locations
Dry eye management typically involves multiple visits — initial evaluation, treatment sessions, and follow-up assessments. With offices in
Morristown,
West Orange, and
Denville, staying consistent with your care plan is easy.
Frequently Asked Questions
What is dry eye disease?
Dry eye disease is a chronic condition in which the eyes fail to maintain a stable, healthy tear film. This occurs either because the eyes don't produce enough tears or because tears evaporate too quickly due to poor oil layer quality from dysfunctional meibomian glands — the most common cause. The result is an unstable ocular surface that causes persistent discomfort, inflammation, and often blurry or fluctuating vision. Dry eye is one of the most common eye conditions, affecting an estimated 16 million Americans.
What causes dry eye?
The most common cause is meibomian gland dysfunction — blockage or atrophy of the oil-producing glands along the eyelid margins. Other causes include aging, hormonal changes (especially in menopausal women), prolonged screen use, contact lens wear, certain medications (antihistamines, antidepressants, blood pressure medications), autoimmune conditions (Sjogren's syndrome, rheumatoid arthritis), prior LASIK or refractive surgery, and environmental factors such as low humidity, wind, or air conditioning. Many dry eye patients have multiple contributing factors simultaneously.
Can dry eye be cured?
Dry eye disease is often a chronic condition that can be managed very effectively but not always permanently cured. The goal of treatment is to stabilize the tear film, reduce ocular surface inflammation, and relieve symptoms so patients can live and work comfortably. Many patients achieve excellent long-term control with a combination of treatments. For some patients — particularly those with meibomian gland dysfunction — advanced in-office treatments like IPL therapy can produce significant and lasting improvement.
What is meibomian gland dysfunction and why does it matter?
Meibomian glands are tiny oil-producing glands along the upper and lower eyelid margins that secrete the oily outer layer of the tear film preventing tears from evaporating too quickly. In meibomian gland dysfunction (MGD), these glands become blocked or atrophied, reducing the oil they produce. Without adequate oil, tears evaporate rapidly and the ocular surface becomes unstable and inflamed. MGD is the most common underlying cause of dry eye disease, present in up to 86% of dry eye patients. Treating MGD directly — rather than just supplementing tears — is essential for lasting relief.
What treatments are available for dry eye disease?
Treatment options range from simple at-home measures to advanced in-office procedures. Mild dry eye is often managed with preservative-free lubricating drops, warm compresses, and omega-3 supplements. Moderate to severe dry eye may require prescription anti-inflammatory drops (Restasis, Cequa, or Xiidra), punctal plugs to retain tears, or in-office meibomian gland expression. Advanced cases benefit from IPL therapy, radiofrequency treatments, or scleral contact lenses for severe ocular surface disease. The appropriate treatment plan depends on the underlying cause and severity of your condition.
What is IPL therapy for dry eye?
IPL (intense pulsed light) therapy is an in-office treatment that uses controlled pulses of light applied to the skin around the eyes to reduce inflammation in the eyelid blood vessels and liquefy congested meibomian glands. Multiple sessions — typically 3 to 4 spaced several weeks apart — are required for optimal results, with maintenance treatments periodically. Many patients experience significant and lasting symptom reduction with IPL that is not achievable with drops or compresses alone. It is one of the most effective treatments currently available for MGD-related dry eye.
Can contact lenses make dry eye worse?
Standard soft contact lenses can significantly worsen dry eye symptoms. They absorb tears from the ocular surface, reduce oxygen to the cornea, and can trigger or amplify ocular surface inflammation. Many dry eye patients find they cannot tolerate soft lenses for significant periods. Paradoxically, scleral contact lenses — large-diameter rigid lenses that vault over the cornea — can actually relieve dry eye symptoms, because the fluid reservoir between the lens and cornea provides continuous corneal hydration throughout wear.
Are prescription eye drops necessary for dry eye?
Prescription eye drops are appropriate for patients with moderate to severe dry eye, particularly those with evidence of chronic ocular surface inflammation. Cyclosporine drops (Restasis or Cequa) reduce immune-mediated inflammation of the tear glands, and lifitegrast drops (Xiidra) block an inflammatory pathway specific to the ocular surface. These work best when used consistently over months and are often combined with other treatments. Not every dry eye patient needs prescription drops — your ophthalmologist will recommend the appropriate treatment based on your examination findings and symptom severity.
