Chronic dry eye is more than just an occasional annoyance—it can become a persistent and painful condition that interferes with daily life. Many people try over-the-counter drops or prescription medications, but in some cases, these treatments fail to provide lasting relief. When that happens, surgery may be the best option.
So, how do you know when surgery is necessary? What procedures are available? And what can you expect from the recovery process? To help you make an informed decision, an eye surgeon in Louisville shares insights into the causes of chronic dry eye, the signs that surgery may be required, and the available treatment options. Additionally, we’ll discuss how to choose the best surgeon for your needs.
Causes of Chronic Dry Eye
Dry eye syndrome develops when the eyes don’t produce enough tears or when the tears evaporate too quickly. While occasional dryness is common, chronic dry eye is a persistent issue that often requires medical intervention. Several factors contribute to this condition, ranging from environmental influences to underlying health conditions.
- Aging
As we grow older, our body’s ability to produce natural tears declines. This is especially common in individuals over 50, making age one of the leading contributors to dry eye syndrome. Women, particularly those undergoing menopause, are at a higher risk due to hormonal changes that affect tear production.
- Environmental Factors
External conditions play a significant role in eye dryness. Exposure to wind, smoke, air conditioning, or dry climates can cause the tears on your eyes’ surface to evaporate too quickly, leading to irritation. People who spend a lot of time outdoors or in controlled indoor environments with low humidity are more susceptible to chronic dryness.
- Prolonged Screen Time
In today’s digital world, excessive screen time is a leading cause of dry eyes. When we stare at screens—whether a computer, phone, or television—our blinking rate decreases. Since blinking helps distribute tears evenly across the eye’s surface, reduced blinking leads to faster tear evaporation and increased dryness.
- Contact Lens Use
Wearing contact lenses for extended periods can cause irritation and dry out the eyes. Some contact lens materials absorb moisture from the eye, exacerbating dryness, especially if worn for too long without proper hydration or lubrication.
- Autoimmune Disorders
Certain health conditions, such as Sjogren’s syndrome, rheumatoid arthritis, and lupus, can cause the body’s immune system to attack moisture-producing glands. This results in reduced tear production and chronic dry eye symptoms that require specialized treatment.
- Medications
Many commonly used medications have dry eye as a side effect. Antihistamines, decongestants, antidepressants, blood pressure medications, and even birth control pills can contribute to decreased tear production. If your dry eyes began after starting a new medication, it’s worth discussing alternatives with your doctor.
- Hormonal Changes
Fluctuations in hormones—whether due to pregnancy, menopause, or hormone replacement therapy—can disrupt tear production. Women, in particular, experience changes in eye moisture levels due to estrogen and progesterone imbalances.
While some of these factors can be managed with lifestyle changes or medications, others may require more advanced treatments, including surgery. If your symptoms persist despite trying conservative treatments, it might be time to consider surgical options.
When Surgery Becomes Necessary
Surgery isn’t the first step in treating dry eye syndrome, but for those who have tried everything else without success, it can be a game-changer. Recognizing when surgery is necessary is crucial to preserving your vision and preventing further damage.
You may need surgery if:
- Your symptoms persist despite using artificial tears, lubricating ointments, or prescription eye drops.
- You experience chronic discomfort, burning, or redness that affects your daily routine.
- Your vision becomes blurry due to corneal damage from prolonged dryness.
- Non-surgical treatments, such as warm compresses or punctal plugs, fail to provide sufficient relief.
If these symptoms sound familiar, consulting an eye surgeon is the best way to determine if a surgical procedure is the right course of action for you. The next step is understanding the different surgical options available.
Types of Dry Eye Surgery
Several surgical procedures can provide lasting relief for chronic dry eye sufferers. The right procedure depends on the underlying cause of dryness and the severity of symptoms.
- Punctal Occlusion (Tear Duct Blocking)
Tears drain from the eyes through small openings called puncta, located in the inner corners of the eyelids. If your eyes lose moisture too quickly, a surgeon can insert punctal plugs to slow down tear drainage.
- Temporary plugs are made of dissolvable materials, allowing patients to test their effectiveness.
- Permanent plugs or cauterization may be performed if the temporary solution proves beneficial.
- LipiFlow® Thermal Pulsation
For individuals with meibomian gland dysfunction (MGD), a leading cause of dry eye, LipiFlow therapy helps unblock oil glands in the eyelids. Using gentle heat and pulsations, this procedure restores the natural oil layer of tears, preventing rapid evaporation.
- Amniotic Membrane Transplant
In severe cases where the cornea has been damaged, an amniotic membrane transplant promotes healing. This procedure involves placing a thin layer of biologic tissue over the eye, reducing inflammation and encouraging natural tissue regeneration.
- Autologous Serum Eye Drops
While not a surgical procedure, these custom-made eye drops—derived from the patient’s own blood—contain growth factors that help repair the eye’s surface and restore moisture.
- Tarsorrhaphy (Partial Eyelid Closure)
For extreme cases where tear evaporation is excessive, a surgeon may partially sew the eyelids together to protect the eyes and retain moisture. This is a last-resort procedure for patients with severe, non-responsive dry eye disease.
Each of these procedures is designed to address a specific cause of dry eye, providing relief when traditional treatments fall short. But what happens after surgery? Understanding the recovery process is just as important.
What to Expect Post-Surgery
Recovery after dry eye surgery varies depending on the procedure, but most patients experience noticeable improvements within weeks. Here’s what you can expect:
- Immediate Post-Procedure Care
- Some redness, irritation, or mild discomfort is common.
- Your doctor will likely prescribe anti-inflammatory and antibiotic eye drops to aid healing.
- Avoid rubbing your eyes to prevent disrupting the surgical site.
- Short-Term Recovery
- LipiFlow patients may notice results within a few weeks as oil glands begin functioning normally.
- Punctal plug patients experience relief almost immediately.
- For procedures involving corneal healing, like amniotic membrane transplants, improvement may take longer.
- Long-Term Results
- Some surgeries offer permanent relief, while others (like LipiFlow) may need repeat treatments over time.
- Routine check-ups ensure the procedure is working effectively.
Selecting a skilled eye surgeon is essential for achieving the best results.
Choosing the Right Surgeon
Finding an experienced specialist is key to successful dry eye treatment. Consider the following:
- Board Certification – Choose an ophthalmologist with expertise in dry eye treatments and surgery.
- Advanced Technology – The best surgeons use cutting-edge diagnostic tools to tailor treatments.
- Patient Reviews – Read testimonials to gauge patient satisfaction and surgical success rates.
- Comprehensive Care – A great surgeon offers long-term post-operative support and follow-ups.
By selecting the right expert, you ensure the highest standard of care for your eyes.
Take the Next Step Toward Relief
Living with chronic dry eye doesn’t have to be a daily struggle. If artificial tears and medications aren’t working, surgical options offer long-lasting relief and a chance to restore comfort. An experienced eye surgeon in Louisville can help determine the best procedure for your needs. Schedule a consultation today to explore your options—your eyes will thank you!
