Understanding Why Your Dry Eye Symptoms Keep Coming Back

If you find yourself reaching for eye drops several times a day, only to experience dryness, burning, or irritation again a short time later, you may be dealing with more than occasional dry eyes.

Over-the-counter artificial tears can provide temporary relief, but they do not always address the underlying cause of chronic dry eye disease.

For many patients, the problem isn't simply a lack of tears. It may involve the quality of those tears and how quickly they evaporate from the surface of the eye.

At North Texas Ophthalmology Associates, we take a personalized approach to diagnosing and treating chronic dry eye. By identifying what's contributing to your symptoms, we can recommend treatments designed to improve tear film stability and support long-term eye comfort.

Why Artificial Tears May Not Be Enough

Artificial tears help lubricate the surface of the eye and can provide relief from dryness and irritation. For patients with mild or occasional symptoms, they may be an effective part of daily eye care.

However, chronic dry eye can develop for several reasons, including:

• Inadequate tear production
• Tears that evaporate too quickly
• Inflammation affecting the ocular surface
• Problems with the oil-producing glands in the eyelids
• Environmental factors such as wind, dry air, and prolonged screen use

In Wichita Falls and throughout North Texas, wind, seasonal allergens, air conditioning, and indoor heating can contribute to dry eye symptoms.

When an underlying problem affects the quality or stability of your tears, adding temporary moisture may not be enough to provide lasting comfort.

Signs It May Be Time for a Dry Eye Evaluation

If over-the-counter drops are no longer providing adequate relief, a comprehensive dry eye evaluation may help identify what's causing your symptoms.

Common signs of chronic dry eye include:

• Burning, stinging, or gritty sensations
• Redness or irritation
• Blurry or fluctuating vision
• Excessive watering or tearing
• Sensitivity to light
• Eye fatigue or discomfort during screen use
• Feeling as though something is in your eye

Interestingly, watery eyes can sometimes be a symptom of dry eye disease. When the tear film becomes unstable, the eyes may produce excess watery tears in response to irritation.

Because these symptoms can have several possible causes, identifying the underlying problem is an important part of determining the appropriate treatment.

What Is Meibomian Gland Dysfunction (MGD)?

One of the common contributors to chronic dry eye is a condition called meibomian gland dysfunction, or MGD.

The meibomian glands are small oil-producing glands located along the edges of your eyelids. These glands produce an oily layer that helps prevent tears from evaporating too quickly.

When the glands become blocked or do not function properly, the tear film may become unstable, allowing moisture to evaporate more rapidly.

This is often referred to as evaporative dry eye.

Patients with MGD may experience ongoing irritation, fluctuating vision, burning, or dryness even when using artificial tears regularly.

While lubricating drops may help manage symptoms, they do not necessarily restore normal oil flow from obstructed meibomian glands.

For appropriate patients, treatments designed to address gland obstruction may provide an additional approach to managing dry eye.

TearCare: A Targeted Treatment for Evaporative Dry Eye

At North Texas Ophthalmology Associates, we offer TearCare, an in-office treatment designed to help address meibomian gland dysfunction, a common cause of evaporative dry eye.

Rather than simply adding moisture to the eye, TearCare focuses on improving the function of the oil-producing glands that help maintain a healthy tear film.

How Does TearCare Work?

TearCare uses controlled, localized heat applied to the eyelids to help soften thickened oils within the meibomian glands.

The treatment generally involves:

1. Gentle heating: Flexible devices are placed on the eyelids to deliver controlled heat while allowing patients to blink naturally.
2. Softening blocked oils: The heat helps loosen thickened oils that may be interfering with normal gland function.
3. Gland expression: Following the heating portion, the eye care provider gently expresses the glands to help release accumulated oils.

By addressing gland obstruction, TearCare may help improve the quality of the tear film and reduce symptoms associated with evaporative dry eye.

What Are the Potential Benefits of TearCare?

For appropriate candidates, TearCare may offer several benefits:

• Improved tear film stability: Supporting the oily layer of the tears may help reduce excessive evaporation.
• Relief from dry eye symptoms: Some patients experience improvements in dryness, burning, irritation, and overall comfort.
• Treatment of an underlying contributor: TearCare targets obstructed meibomian glands rather than relying solely on temporary lubrication.
• An in-office treatment option: The procedure is performed without surgical incisions.
• Potential for continued symptom management: TearCare may be incorporated into a broader, individualized dry eye treatment plan.

Results vary, and TearCare does not cure every form of dry eye. Patients with inadequate tear production, significant ocular surface inflammation, or other contributing conditions may need additional treatments.

Why Some Patients Return for Additional TearCare Treatments

One encouraging thing we've seen at North Texas Ophthalmology Associates is that patients have expressed interest in returning for additional TearCare treatments.

For patients who experience improvement in their symptoms, maintaining eye comfort can become an important part of their ongoing dry eye management.

Because meibomian gland dysfunction can be chronic, some patients may benefit from repeat treatment depending on their symptoms, gland function, and response to their initial procedure.

The timing and need for additional treatments are determined individually.

Our goal is not simply to provide temporary relief, but to help patients develop a long-term approach to managing their dry eye symptoms and maintaining a healthier ocular surface.

What Other Advanced Dry Eye Treatments Are Available?

TearCare is one of several treatment options available at North Texas Ophthalmology Associates.

Depending on the cause and severity of dry eye, additional treatments may include:

Autologous Serum Tears

These specially prepared eye drops are made using components of a patient's own blood and contain naturally occurring substances that may help support healing of the ocular surface in certain patients with more complex dry eye disease.

Amniotic Membrane Therapy

Amniotic membrane treatment may be recommended for certain patients with significant ocular surface damage or inflammation. The membrane can help support healing and recovery of the eye's surface.

Individualized Medical Management

Some patients may also benefit from prescription medications, appropriate lubricating drops, eyelid care, and adjustments to environmental or lifestyle factors.

Not every patient needs advanced treatment. The appropriate approach depends on identifying the specific factors contributing to their symptoms.

Frequently Asked Questions About Chronic Dry Eye and TearCare

Why do my eyes still feel dry even when I use artificial tears?

Artificial tears provide lubrication, but they may not address underlying problems such as meibomian gland dysfunction, inflammation, or inadequate tear production. If symptoms continue despite regular use, a dry eye evaluation can help identify other treatment options.

What is the difference between TearCare and regular eye drops?

Artificial tears temporarily lubricate the eye's surface. TearCare is an in-office treatment designed to address obstructed meibomian glands that contribute to evaporative dry eye. They serve different purposes and may be used together as part of a treatment plan.

Is TearCare painful?

TearCare is designed to deliver controlled heat to the eyelids. Patients may feel warmth during treatment and some pressure or discomfort during gland expression. Individual experiences can vary.

How long do TearCare results last?

The duration of improvement varies from patient to patient. Because meibomian gland dysfunction can be chronic, some patients may experience recurring symptoms and benefit from additional treatment or ongoing maintenance.

Can I have TearCare more than once?

Yes. Repeat TearCare treatments may be appropriate for some patients depending on their symptoms, gland function, and response to previous treatment. Your eye care provider can help determine whether another treatment would be beneficial.

Is TearCare right for everyone with dry eye?

No. TearCare is primarily intended for patients with evaporative dry eye associated with meibomian gland dysfunction. Patients whose symptoms are caused by other conditions may benefit from different treatments.

A dry eye evaluation is necessary to determine which treatment is most appropriate.

Advanced Dry Eye Treatment in Wichita Falls

Chronic dry eye can affect much more than how your eyes feel. Persistent irritation, fluctuating vision, and discomfort during everyday activities can interfere with reading, computer use, driving, and overall quality of life.

At North Texas Ophthalmology Associates, we provide specialized dry eye evaluations and treatment options for patients throughout Wichita Falls, North Texas, and Southern Oklahoma.

Our approach focuses on identifying the cause of your symptoms and developing a treatment plan that may include TearCare, medical management, or other advanced therapies when appropriate.

Schedule Your Dry Eye Evaluation

If you're using artificial tears throughout the day without lasting relief, it may be time to look beyond over-the-counter drops.

A dry eye evaluation can help determine whether meibomian gland dysfunction or another condition is contributing to your symptoms and whether TearCare or another treatment may be appropriate.

Schedule an appointment with North Texas Ophthalmology Associates or call (940) 240-8400.

Medically Reviewed By

This article has been medically reviewed by Dr. Robert L. Staples, optometrist at North Texas Ophthalmology Associates, before publication.

Dr. Staples provides specialized dry eye and ocular surface care, helping patients identify the underlying causes of their symptoms and explore treatment options based on their individual eye health needs.