Dry Eye Disease

Frequently Asked Questions

What causes dry eye disease?

Dry eye disease is caused by insufficient tear production, poor tear quality, or excessive tear evaporation. Common causes include meibomian gland dysfunction (the most common), aging, autoimmune disease (Sjögren's syndrome), eyelid malposition, post-LASIK changes, and certain medications.

When does an oculoplastic surgeon treat dry eye?

Oculoplastic surgeons treat dry eye when the cause is structural — such as eyelid malposition (ectropion, entropion), incomplete eyelid closure (lagophthalmos), or after eyelid or orbital surgery. They also place punctal plugs to reduce tear drainage and manage ocular surface disease in the perioperative setting.

What is the difference between Restasis and Xiidra?

Both are prescription eye drops for dry eye disease, but they work differently. Restasis (cyclosporine) suppresses inflammation that damages tear-producing cells. Xiidra (lifitegrast) blocks a specific inflammatory pathway (LFA-1/ICAM-1 interaction). Both take weeks to months for full effect.

Do punctal plugs help dry eye?

Yes. Punctal plugs are small biocompatible devices inserted into the tear drainage openings (puncta) to reduce drainage and keep natural tears on the eye surface longer. They are a simple office procedure and are often used when eye drops alone are insufficient.

What should I expect during a dry eye consultation with an oculoplastic surgeon?

During your consultation, your surgeon will perform a comprehensive evaluation including tear production testing, tear film analysis, and examination of your eyelid position and closure. They'll review your symptoms, medical history, and previous treatments to determine which management approach—from conservative measures to surgical intervention—is best suited for your specific condition. This thorough assessment ensures your treatment plan addresses the underlying cause of your dry eye rather than just symptoms.

What are the potential risks and complications of dry eye surgery?

Like any surgical procedure, dry eye treatments carry potential risks including infection, bleeding, and temporary discomfort or irritation. Specific complications depend on the procedure; for example, eyelid tightening surgery may temporarily affect lid sensation, while exposure correction surgeries rarely have serious complications but require proper healing. Your surgeon will discuss all risks specific to your recommended procedure and explain how they minimize these risks through their surgical expertise and technique.

How long does it take to see improvement after dry eye treatment?

Timeline varies depending on the type of treatment: punctal plugs may provide relief within days, while prescription medications typically show improvement over 4-12 weeks of consistent use. Surgical procedures for exposure or lagophthalmos generally show results within the first few weeks, with continued improvement over 2-3 months as healing completes. Your surgeon will provide specific expectations based on your chosen treatment and help you understand the recovery process.