Professional Dry Eye Surgery in New York, NY
What is Dry Eye?
Dry Eye/Blepharitis occurs most often when the meibomian glands on the eyelids become inflamed or clogged (meibomian gland dysfunction, or MGD). Meibomian glands produce the lipid, or oil, that stabilize the tear film and prevent it from immediately evaporating. When the lipid layer is not present, tears will evaporate too quickly. Dry eye/Blepharitis can also develop when the eyelids do not close properly or when the lacrimal glands of the eye fail to produce enough lubricating tears.
Patients at risk include women experiencing age-related hormonal changes, those eating a diet that is low on vitamin A or low in omega-3 fatty acids, individuals with certain allergies, on medication for allergies, or being on other drugs where the dry eye/Blepharitis may be a side effect, like birth control pills or antidepressants. The prevalence of dry eye also increases with age, more than 25 million people in the U.S. suffer from dry eye.
Symptoms of Dry eye/Blepharitis can range from mild to severe and include eye discomfort or irritation, grittiness, the feeling of a foreign body in the eye, a burning or stinging sensation, continuous tearing, redness, discharge, itchiness, sensitivity to light, difficulty reading, or being on a computer, inability to wear contact lenses or a constant need for lubricating eye drops.
NYC Dry Eye Specialists
Board-certified eye surgeon Dr. Sandra Belmont is a talented dry eye doctor in New York City. Dr Belmont provides dry eye treatment by implementing a number of these approaches simultaneously. Contact our Manhattan dry eye centre today to schedule a consultation and receive a personalized evaluation to assess the severity of your condition
What Is Blepharitis?
Blepharitis (blef-uh-RYE-tis) is an ocular surface disorder that consists of an inflammation of the eyelid margin. This results most often when the meibomian glands, the oil glands located near the base of the lids, close to the eyelashes (see illustration), get clogged. The condition is typically chronic and characterized by recurring acute flare-ups. Symptoms include swelling or thickening of the eyelids, scaling, crusting or redness on the lid margin, gritty eyes, missing or misdirected eyelashes, and most often, greasy or flaky scales at the base of the lashes. If not treated, the inflammation can lead to substantial notching and scarring of the lid margin.
Patients that are at risk for Blepharitis include individuals with systemic diseases such as dermatitis, and patients with ocular surface disorders like dry eye, meibomian gland dysfunction (MGD), conjunctivitis or keratitis. The incidence of blepharitis, dry eye and meibomian gland dysfunction also increases with age and with the use of certain medications. NYC patients who suffer from blepharitis can treat their condition by visiting Dr. Sandra Belmont and discussing the right treatment plan.
Treatments For Blepharitis
Blepharitis treatments differ depending on the severity of the case.
In mild cases, an at home, warm compress routine, along with lid hygiene and lid scrubbing (see our page for lid scrub instructions*) will suffice. Adhering to the routine can prove to be a bit much for some patients as it is rather labor intensive. Doing the compress while at the sink or in the shower may help in integrating it into a more viable daily routine. Over-the-counter lid cleaning pads may also be used for the lid scrub. It is important to remember here that the more diligent the patient is, the better the results will be.
Lipiflow
Lipiflow is a relatively new procedure available for moderate to more severe cases which is at present not covered by insurance. The 12 minutes, the in-office procedure works directly on the meibomian glands through a thermal pulsation system that applies gentle, controlled heat to the inner eyelid along with an adaptive pressure. These serve to unblock the meibomian glands on the eyelids and to encourage the body to restart the natural secretion and production of lipids (oils) produced by the meibomian glands that are necessary for a healthy tear film. Lipiflow is also used for the treatment of dry eye and meibomian gland dysfunction (MGD) which can, when left untreated, lead to chronic blepharitis.
Blephex®
BlephEx is a painless, in-office treatment that Dr. Belmont performs for the management and prevention of blepharitis, a pathological condition where the eyelids and lid margins become inflamed due to an overgrowth of the normal bacteria that live on the lids and base of the eyelashes.
Blepharitis is considered to be the most undertreated eye disease. As it progresses, the ailment leads to redness, itching, constant eye irritation, inflammation, and swelling. Left untreated, the biofilm build up becomes a host to bacterial exotoxins that will adversely affect other structures in the lids including the tear ducts, lacrimal and meibomian glands and lead to evaporative dry eye disease, contact lens intolerance, meibomian gland dysfunction and corneal ulceration.
BlephEx thoroughly cleans the lid margins and removes the sugary biofilm that lets bad bacteria flourish. In the process, the overall health of the eyelids is greatly improved. With a healthier biofilm, the meibomian glands and tear ducts can begin to function more effectively once again. As this happens, the outer lipid layer of the tear film is stabilized and stops evaporating too rapidly and causing dry spots. Patients can start to produce more of their own tears to finally find relief from the chronic symptoms of blepharitis and dry eye disease.
The BlephEx instrument spins a patented, sterile micro-sponge on the edge of the eyelids, lid margin and lashes. A fresh, sterile, disposable micro-sponge is used for each individual lid. With great accuracy and safety, scurf and debris are removed. The eyelids are also exfoliated to promote a more hygienic lid margin and a restored, healthier biofilm. Numbing drops are used on the eyes prior to the procedure to insure patient comfort. Most patients report nothing more than a tickling sensation in the course of treatment. The whole process takes less than 10 minutes after which the eyes are thoroughly rinsed.
After the procedure, patients are instructed on how to maintain their clean eyelids with regular nightly lid hygiene. BlephEx can be repeated annually or in 4-6 month intervals if necessary to keep blepharitis in check where home treatments prove to be less than optimal.
For patients with moderate blepharitis who are about to undergo cataract surgery or laser vision correction, BlephEx is an ideal pre-operative treatment to decrease biofilm and bacterial exotoxins on the lid margins that may slow down recovery following surgery.
Expression of the Meibomian Glands (MGX)
The meibomian glands are specialized sebaceous glands located in the upper and lower eyelids, responsible for producing the oily layer of the tear film. These glands play a crucial role in maintaining proper eye lubrication by preventing tear evaporation. Each eyelid contains approximately 25 to 40 meibomian glands, which release lipids that mix with the aqueous and mucous layers of the tears, forming a stable tear film.
In patients with dry eye syndrome, meibomian gland dysfunction (MGD) is often a contributing factor. Blockages or dysfunction in these glands leads to insufficient lipid production, resulting in rapid tear evaporation and dryness of the eyes. To address this, Dr. Belmont performs a procedure known as meibomian gland expression (MGX). During the procedure, Dr. Belmont applies a gentle pressure to the eyelids to express the trapped meibomian gland secretions on each gland. Clearing these blockages helps to restore the natural flow of lipids on the ocular surface and improve tear stability.
Meibomian gland expression relieves the symptoms of evaporative dry eye, which can include irritation, redness, and discomfort. Dr. Belmont states that “the frequency of this treatment depends on the severity of the condition; some patients may need MGX done regularly, while others may require it less frequently. Typically, it’s recommended every few months, or as needed, based on individual patient response.
Uncloud Your Vision Today
If you are tired of looking at your loved ones’ faces and other images through a cloudy veil, start on your way to achieving unclouded vision today.
To schedule an appointment with Dr. Belmont or to learn more about cataract surgery and your IOL options, please contact Belmont Eye Center by calling (212) 486-2020.
When Should You See a Dry Eye Specialist?
Dry eye that keeps coming back deserves more than another bottle of eye drops. Frequent redness, burning, morning irritation, light sensitivity, or blurred vision can signal a problem that needs a closer examination. Contact lens discomfort can also be a warning sign, particularly when once-comfortable lenses become difficult to wear.
During an evaluation, a specialist can examine the tear film and meibomian glands to identify problems affecting the surface of the eye. The goal is to understand what is causing your symptoms rather than simply managing them for a short time. For some patients, treating meibomian gland dysfunction or inflammation may make a greater difference than relying on artificial tears alone. A healthy ocular surface also matters before LASIK eye surgery. Patients with untreated dry eye may experience greater discomfort or visual fluctuations after surgery, so addressing these concerns beforehand can be an important part of surgical planning.
When Is Dry Eye Treatment Needed?
Persistent symptoms may call for a more detailed treatment plan. Chronic dry eye surgery may be considered for certain patients, depending on the underlying condition and examination findings. At Belmont Eye Center, we take a personalized approach to determining the most appropriate treatment for your eyes.
Concerned about ongoing irritation, light sensitivity, blurred vision, or contact lens discomfort? Contact Belmont Eye Center to arrange a comprehensive dry eye evaluation.
FREQUENTLY ASKED QUESTIONS
Mild symptoms may improve after changes to your environment or daily habits. Persistent or worsening symptoms, however, may indicate an underlying condition that needs professional evaluation.
The timeline varies based on the cause and treatment. Some patients notice relief quickly, while others need ongoing care before symptoms improve. Your specialist can explain what to expect after examining your eyes. Treatments that address the underlying cause may take longer to show their full effect than temporary lubricating drops. Regular follow-up visits can also help determine whether your treatment needs to be adjusted as your eyes respond.
Treatment can improve gland function and relieve symptoms in many patients, although results depend on the glands’ condition and how long the problem has been present. Early evaluation may help prevent the condition from becoming more difficult to manage.
Yes. Some people notice greater irritation at night or upon waking. Dry indoor air and incomplete eyelid closure during sleep can contribute to overnight discomfort.
Staying hydrated supports normal body function, but drinking more water alone is unlikely to resolve persistent dry eye. Environmental factors and the underlying cause of the condition also matter.
