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ReFocus

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.

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Spotlight on Care: Manchester's Favorite Optometrist

Meet Dr. Michael Philip Goldstein, O.D.

With more than 20 years of experience, Dr. Michael Goldstein specializes in medical optometry and family eye care. His dedication to providing personalized, expert treatment ensures patients of all ages receive the highest standard of care.

Awards & Leadership Highlights

  •  Recognized leader in the field as a certified speaker for the American Board of Opticianry, providing educational content for industry professionals.
  • 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 and very thorough, explaining his findings in layman’s terms. He is a very friendly & humorous gentleman. I would refer people to him.”
  • “I highly recommended him, I took my daughter 6 yrs old, 2 weeks ago for her yearly check up, it was our first appointment with him. He was really friendly with her, made her feel comfortable during the examination, explain every detail on what they find during the examination“
  • I was pleased to meet Dr. Goldstein yesterday. My eyes were checked thoroughly; and much to my relief there is help for my dry eye problem.”
  • “Dr. Goldstein saw my 13 year old son for a complete eye exam, Dr. Goldstein was absolutely amazing, our entire experience was wonderful, from the second we walked in. Bravo to Manchester Refocus for having an amazing team, I’ve already referred family members and will be continuing, I most definitely give Refocus ⭐️⭐️⭐️⭐️⭐️”
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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.
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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.

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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.

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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.

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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.

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          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.

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                  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.