Keith Roach, MD, Syndicated Columnist
Dear Dr. Roach: I developed chronic dry eye after having cataract surgery in both eyes. I consulted an ophthalmologist who specializes in dry eye treatment.
She prescribed Restasis, but her symptoms did not improve after 3 months of use. Then she switched me to her Xiidra and she also told me to refill it twice and that lasted her 9 months.
At the end of my conversation with my dry eye specialist, she said she had done everything she could for me. She inquired about the recently approved Meebo drug and LipiFlow surgery.
She muttered something and then said. “Goodbye” and “Good luck.” Did she openly admit her incompetence? — KJW
Answer: It is unlikely that a dry eye specialist would be unaware of new treatments available in their specialty, so we can only assume that there was some misunderstanding. As a generalist, I am not a specialist who knows a lot about just a few symptoms, but I need to know at least a little about many symptoms.
It is common for most people who suffer from dry eyes to start using artificial tears, and while it is effective for many, I have certainly found that using artificial tears multiple times a day can be uncomfortable. I experienced a patient who had persistent symptoms. It is also recommended to avoid dry locations, especially those with high ventilation.
Most people with dry eye have clogged meibomian glands, which secrete an oily substance that prevents eye fluid from drying out and stimulates the lacrimal glands to produce tears.
(This leads to the paradox of having red, watery eyes when you actually have dry eye disease.) Trying to unclog the meibomian glands with baby shampoo and warm water This is another treatment that general practitioners like me often try.
However, if these treatments are ineffective, consultation with an ophthalmologist is essential.
Your eye doctor can perform a test to see if your meibomian glands are blocked.
Editor's note: Readers can email questions to ToYourGoodHealth@med.cornell.edu.
