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Dry Eye in Houston, TX

If you are troubled with dry eye syndrome, board-certified ophthalmologist Mary T. Green, M.D., Ph.D., F.A.C.S. at Eye Excellence, located in Houston and serving Missouri City and the surrounding areas of Texas, can help you with this common eye problem.

What is Dry Eye?

Eye Excellence, one of the leading dry eye centers in Houston, sees hundreds of dry eye patients each year. Dry eye is a very common condition in which the eye does not have an adequate amount of tears needed to properly lubricate the eye. This deficiency in tears can cause the eye to become irritated, itchy and sometimes even painful. Dry eye syndrome, also called dry eye disease or dry eye, occurs when people either do not produce enough tears or have a poor quality of tears.

Types of Dry Eye

Dry eye syndrome occurs when people either do not produce enough tears or have a poor quality of tears. These two categories are called aqueous tear-deficient dry eye and evaporative dry eye.


  • Aqueous Tear-Deficient Dry Eye – Your eye’s tears (aqueous) are created by several glands within and around the eyelids. Tear production may diminish with certain medical conditions, as we age or if we take certain medications. Smoking can also reduce the amount of tears our eyes produce. Living in certain climates with low humidity or windy conditions can also cause this type of dry eye to occur. Because of the humidity in Houston, we see fewer patients for this type of dry eye than a practice in Denver would see.
  • Evaporative Dry Eye – This is the most common form of dry eye. Your tears or tear film are made up of three layers: oil, water and mucus. Each layer is important for keeping your eyes moist and comfortable. Evaporative dry eye occurs when the oil layer of the tear film becomes deficient. Your oil layer helps trap the aqueous or “tears” from evaporating away. Think of it this way. Picture a glass of water with olive oil in the glass, which has floated to the top of the glass. If you leave the glass outside, the water will evaporate at a much slower rate because it is trapped in the glass by the oil. If there were no oil in the glass, the water would evaporate very quickly. The same is true for your eyes. If your oil layer is deficient, then your tears will have nothing to protect them and will, therefore, more easily evaporate away. This type of dry eye is usually caused by a malfunction in your Meibomian glands. Your Meibomian glands are responsible for producing the oils that coat the eye.

Symptoms of Dry Eye

  • Stinging or burning eyes
  • Scratchiness
  • Stringy mucus in or around the eyes
  • Excessive eye irritation
  • Difficulty wearing contact lenses
  • Excessive tearing

Many patients are surprised or confused by the last item on the list above — excessive tearing. How can your eyes be dry if they have many tears, especially too many tears? This is due to a reflex of the eye. When the body detects that the surfaces of the eyes are dry, the lacrimal glands release tears. Naturally, tears would seem like the way to solve the dryness problem. However, for many patients, they’re just not good enough. If a patient’s tears are of poor quality (detailed below), then the eyes will constantly become watery in reaction to the eye’s constant dryness.

Normal Tear Film

Without a healthy tear film, proper vision is not possible. There are three layers of the tear film: an oil layer, an aqueous layer, and a mucin layer.

The oil layer, which is the outermost layer, smooths the tear surface and reduces the evaporation rate of tears. The watery, aqueous middle layer cleanses the eye and washes away irritants. The inner mucin layer helps the watery layer spread evenly over the surface of the eye and helps the eye remain moist.

Causes of Dry Eye

Tear production normally decreases as people age. Men and women both are affected by dry eye. However, it is most common in women after they reach menopause. Dry eye can also be associated with certain health conditions. Be sure to tell your eye doctor the names of all the medications you are taking, especially if you are using diuretics, beta-blockers, antihistamines, sleeping pills, antianxiety medications and pain relievers.

What Is MGD or Meibomian Gland Dysfunction?

Your eye’s tears are made up of multiple layers called the tear film. The innermost portion is called the Mucin Layer, the middle layer is called Water Layer and lastly the Lipid Layer, which is on the outermost layer of the cornea. The lipid layer keeps the water layer “trapped” so the watery tears do not evaporate away. Your eye has a special gland called the Meibomian gland, which is responsible for the production of lipid oil. If the glands become blocked, oil output is diminished and the lipid layer becomes broken and the water layer can evaporate.

Diagnosing Dry Eye

Dry eye is diagnosed by a series of tests to determine tear quantity and quality. The Schirmer tear test involves placing filter-paper strips under the lower eyelids to measure the rate of tear production under various conditions. A separate test uses a diagnostic drop to look at certain patterns of dryness on the surface of the eye. The TearLab™ Osmolarity Test determines the adequacy of the aqueous component of one’s tears. For severe dry eye, other laboratory testing is also performed.

Dry Eye Treatment Options

Warm Compresses

At Eye Excellence, we like to start from easy, inexpensive treatment possibilities before we move to options that are invasive or more costly. For dry eye patients, we are often able to help them alleviate their symptoms using nothing more than common household items. This technique, called warm compresses, can allow the Meibomian glands to resume normal function.

To try warm compresses for yourself, all you will need is a washcloth and a microwave. Take the washcloth and dampen it with tap water. Place the damp washcloth in the microwave (on a plate if you wish) and warm it up for approximately 15 seconds so that it is warm — but not hot. It should be cool enough to hold in your hands.

Find a place to sit where you can lean your head back. With your head back, place the washcloth over your eyes. The warmth of the washcloth can reliquify oil blocks in the Meibomian (oil) glands. By allowing the oil glands to establish a healthy oil layer on the eye, your tears will not evaporate too quickly. Note that this treatment is most effective for patients who only have an oil layer deficiency. Patients who lack enough tears will likely continue to have dry eye symptoms.

Artificial Tears

Artificial tears can be used to supplement your own tears and are available without a prescription. Artificial tears can help patients who have healthy tears that are simply not enough. Also, patients with evaporative dry eye will find temporary symptom relief from artificial tears. Ophthalmologists like artificial tears because they can be applied liberally, even every 30 minutes if needed. However, they treat only the symptom, not the cause. We recommend using preservative-free eye drops, primarily because other eye drops may contain astringents that will further irritate the eyes. Also, the prescription medication Restasis helps decrease inflammation in the lacrimal gland and in turn, helps you produce better quality tears.

In general, artificial tears can help patients with any form of dry eye feel more comfortable. Also, they can prevent complications that may arise from the eyes being too dry. If you have dry eye, consider keeping some artificial tears with you at all times. Certain buildings or climates may be particularly irritating to one’s eyes, inducing a gritty or sandy sensation. Plan ahead and you’ll be fine.

MiBoFlo ThermoFlo®


In the past, eye doctors would have patients with MGD use warm compresses to help improve lipid flow. Now, a much more advanced method has arrived, MiBoFlo ThermoFlo®. This revolutionary treatment works by gently massaging the eyelids and Meibomian glands with warm back and forth pressure. This allows for improved function of the Meibomian glands and increased lipid oil production. The increase in oil production can greatly improve dry eye symptoms in patients suffering from dry eye caused from Meibomian gland dysfunction.


BlephEx™ is a new, in-office procedure that allows the clinician to take an active role in treating blepharitis, inflammation of the eyelid margins. BlephEx™ reduces scurf and bacterial debris, the main causes of inflammatory lid disease, and improves the overall health of the eyelid. Removing this harmful material from the lids margins is similar in concept to having plaque removed from your teeth. Patients can enjoy a life free from the chronic and irritating symptoms associated with blepharitis. The BlephEx™ treatment is well tolerated and only takes a few minutes to perform. BlephEx™ can save the patient hundreds of dollars in the costs of prescription drops and artificial tears.

How Much Does Treatment for Dry Eye Cost?

  • Even if your insurance plan doesn’t cover vision correction, you can use cash, a credit card, or approved financing for payment.
  • Choose from no-interest plans, extended payment options up to 48 months and no down payment.

Please visit our financing page for more information.

If you live in Houston, Missouri City or the surrounding areas of Texas and are troubled with dry eye syndrome, Dr. Green, our board-certified ophthalmologist at Eye Excellence, can help you manage or cure this common eye problem. Contact us today.

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