Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Different minor surgical procedures may help in the treatment of DES.
Near the inner corner of each eyelid are small
openings, called punctae, that are the beginning of the normal tear drainage
system. A procedure known as punctal occlusion can help by decreasing the normal drainage of your tears off the eye and down the tear drainage system, into the back of your nose, and down your throat. This occlusion is usually a very simple office procedure and only takes a few minutes.
Different punctal plugs or lacrimal canalicular plugs can be placed at or just inside these openings to block the normal drainage of tears down the tear drainage system. Just like a stopper that you put in the drain of a sink to
keep the water from flowing down the drain, these plugs keep the tears that
you have from flowing down the tear drainage system. Therefore, your eyes
stay more moist and comfortable, even if you have fewer tears. These plugs
can usually be removed very easily, if necessary.
Sometimes, in severe cases of DES, these openings are permanently closed, usually by cautery (burning)
or laser. This
accomplishes the same thing as the plugs, but it is very difficult, if not
impossible, to reverse.
If you have difficulty closing your eyes for any reason, your eye may dry out because of tear evaporation.
Lateral tarsorrhaphy is a procedure during which
the lateral (outside) one-third of your eyelids are sewn together to
decrease the ability of your eye to open widely and to help your eye close
If stroke or nerve damage keeps your eyelids from closing properly, a small gold weight may be implanted into your upper eyelid to help it close.
Dry eye is a multifactorial disease of the tears and the ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface.