Dry Eye TreatmentIn Manchester

Dry eye disease is more than just an annoyance—it’s a condition that affects your comfort, vision, and quality of life. At ReFocus Eye Health in Manchester, our eye doctors diagnose and treat dry eye with precision and care, offering cutting-edge therapies tailored to your unique needs. Whether it’s addressing inadequate tear production or tackling the root causes of tear film instability, we’re here to help restore clarity, comfort, and confidence to your daily life.

Request an Appointment

Spotlight on Care: Manchester's Favorite Optometrist

Meet Dr. Michael Philip Goldstein, O.D.

Awards & Leadership Highlights

Over 20 years of experience as an accomplished optometrist specializing in medical optometry and family eye care.
Graduated from the New England College of Optometry in 2000, showcasing a strong foundation in advanced clinical training.
Recognized speaker for the American Board of Opticianry, delivering continuing education lectures for professionals in the field.
Contributed to optometric research and publications, advancing knowledge and best practices within the profession.

What Patients Say About Dr. Goldstein

“Dr Michael Goldstein was wonderful very thorough, explained his findings in layman’s terms. He is a very friendly & humorous gentleman. I would refer people to him. His tech Amy was also very friendly and thorough. Very nice office entire staff is very friendly and knowledgeable.”

Welcoming New Patients

What is Dry Eye?

Dry eye, or dry eye disease (DED), is a condition where the eyes don’t produce enough tears, or the tears lack the quality needed to maintain moisture and comfort. Tears are essential for protecting, lubricating, and nourishing the eye’s surface. When this system falters, it can lead to discomfort, vision issues, and even long-term damage.

Dry eye can stem from either:

Inadequate tear production

The lacrimal glands fail to supply enough tears.

Poor tear quality or rapid evaporation

Tears lack essential components, making them unstable.

4.8 (758 reviews) on Google

The Highest Rated Eye Care Center In Manchester

What Patients are saying?

The staff was accommodating, and everyone there went the extra mile to take care of my vision needs. Especially happy with the Dr for taking the time to find a solution for my impaired vision. I highly recommend!

★★★★★

Jack P

18 December 2024

I was able to get checked in quickly. There was only a short wait for Dr. Stabiel. As always she was very thorough and helpful. Checkout was smooth.

★★★★★

George L

4 December 2024

How Tears Work: The Architecture of the Tear Film

The tear film is a three-layered structure, each contributing to stability and function:

Lipid Layer (Outer)

Derived from meibomian glands.
Reduces evaporation by forming a hydrophobic barrier.
Dysfunction in this layer leads to increased evaporation and instability.

Aqueous Layer (Middle)

Produced by lacrimal and accessory glands.
Composed of water, electrolytes, and proteins essential for hydration and immune defense.
Deficiency in this layer leads to hyperosmolarity and epithelial stress.

Mucin Layer (Inner)

Secreted by goblet cells in the conjunctiva.
Ensures even tear distribution by binding the aqueous layer to the ocular surface.
Mucin deficiencies result in patchy tear coverage and surface irregularities.

Mechanisms Behind Tear Film Dysfunction

Aqueous Tear Deficiency

A lack of adequate tear volume can occur due to:

Lacrimal Gland Dysfunction: Autoimmune diseases like Sjögren’s syndrome attack glandular tissue, reducing secretion.
Obstruction of Tear Ducts: Scarring or damage can impede tear flow.
Age-Related Changes: Reduced gland activity is common with aging.

Increased Tear Evaporation

Excessive tear evaporation, a hallmark of evaporative dry eye, often involves:

Meibomian Gland Dysfunction (MGD):
- Blockages or atrophy in these glands reduce lipid secretion.
- Leads to instability of the tear film and rapid evaporation.
Environmental Stressors:
- Low humidity, wind, and smoke exacerbate evaporation.
Incomplete Blinking:
- Reduced blinking, especially during screen use, prevents even tear distribution and lipid layer replenishment.

Tear Hyperosmolarity

When tear production decreases or evaporation increases, tear concentration (osmolarity) rises. This hyperosmolarity:

Triggers apoptosis in corneal epithelial cells.
Induces the release of pro-inflammatory mediators.
Amplifies ocular surface inflammation, creating a vicious cycle.

The Role of Inflammation in Dry Eye

Reduce mucin production

Damage goblet cells, reducing mucin production.

Worsen tear film stability

Disrupt epithelial integrity, further destabilizing the tear film.

Prolong dysfunction

Induce chronic inflammation that perpetuates the cycle of dysfunction.

Book an Appointment Today With Manchester’s Leading Eye Care Team

Our experienced eye doctors and surgeons are here to help you enjoy life with crisp, clear, and comfortable vision. Schedule with our eye doctors for the highest standard of care.

Request an Appointment

Ocular Surface Damage: A Cascade of Effects

The ocular surface depends on a healthy tear film to function. When tears are inadequate:

Epithelial Erosion

Unprotected corneal cells are prone to injury.

Loss of Corneal Sensation

Damage to corneal nerves disrupts the feedback loop for tear production.

Increased Susceptibility to Infection

The loss of antimicrobial proteins leaves the eye vulnerable.

Symptoms of Dry Eye: It’s More Than Just “Dryness”

Dry eye manifests in various ways:

Common Symptoms

Dryness, burning, redness, itching, and a gritty sensation.

Vision-Related Issues

Blurry vision, light sensitivity, and halos around lights.

Physical Signs

Reflexive watery eyes, discharge, and crusting on eyelids.

Causes of Dry Eye

Dry eye is a complex condition with multiple causes, including:

Age and Hormonal Changes

Menopause, pregnancy, or hormone therapy can affect tear production.

Medications

Antihistamines, antidepressants, and glaucoma treatments are common culprits.

Medical Conditions

Autoimmune diseases like Sjögren’s syndrome and rheumatoid arthritis.

Environmental Factors

Exposure to smoke, wind, or prolonged screen time.

Mechanical Issues

Eyelid disorders and incomplete blinking.

Evaluating Dry Eye: Diagnostic Mechanisms

Accurate diagnosis focuses on identifying tear film abnormalities:

Tear Break-Up Time (TBUT)

Measures tear film stability.
Short TBUT indicates lipid layer dysfunction or evaporation issues.

Osmolarity Testing

Elevated osmolarity confirms hyperosmolar tears.

Meibomian Gland Imaging

Identifies gland blockages or atrophy.

Corneal and Conjunctival Staining

Detects epithelial damage using dyes like fluorescein or lissamine green.

Patient History

Medications, lifestyle, and family history provide valuable insights.

Treating Dry Eye by Targeting Mechanisms

Effective treatment strategies address specific mechanisms:

Improving Lipid Layer Function

Warm compresses and lid massages stimulate meibomian gland secretion.
Lipid-based artificial tears restore layer stability.

Enhancing Tear Production

Medications like cyclosporine (Restasis) and lifitegrast (Xiidra) reduce inflammation and boost lacrimal output.
Punctal plugs preserve existing tears.

Reducing Inflammation

Short-term corticosteroids alleviate acute inflammation.
Omega-3 supplements may reduce systemic inflammation.

Protecting the Ocular Surface

Scleral lenses shield the cornea and maintain hydration.
Amniotic membranes promote epithelial healing.

Lifestyle & Environmental Modifications

Use of warm compresses and hydration.
Reducing screen time and improving blinking habits.
Humidifiers to combat dry air.
Avoiding smoke or direct wind exposure.

A Dynamic System in Balance

Dry eye disease exemplifies the interplay between structural integrity, biochemical stability, and environmental influences. Addressing the mechanisms behind tear film dysfunction—whether through medical intervention, lifestyle adjustments, or environmental modifications—provides the foundation for restoring ocular health. By targeting these pathways, we not only alleviate symptoms but also disrupt the cycles of damage and inflammation that define this complex condition.

Don’t Wait Schedule a Dry Eye Evaluation Today in Manchester

Dry eye isn’t just uncomfortable—it’s a progressive condition that can lead to serious complications. From corneal damage to permanent vision loss, early intervention is essential. Working closely with an eye care specialist ensures treatment is personalized to your unique needs, offering relief and preserving long-term eye health.

At ReFocus Eye Health Manchester, we are dedicated to providing top-tier medical eye care services to patients throughout Hartford County. Our advanced clinic is equipped to manage a wide range of eye conditions, with a skilled team of eye doctors ready to deliver personalized care. Patients from Manchester, East Hartford, South Windsor, Vernon, and other surrounding areas trust us for dry eye treatment.

Contact Us

Make An Appointment

860-432-6192

Demodex Blepharitis: The Hidden Culprit Behind Eye Irritation