Dry Eye Therapy

Conveniently located to serve Honolulu and Hawaii

Patient Testimonial

I have been seeing Dr. Tantisira for several years now. Initially I went to see her for the fractional CO2 laser. Not even fully understanding it’s true benefits. Of course I was so happy with the way I “looked”. I looked so much younger! Then I went in for some Botox and fillers. Again I was thrilled with my results. A couple years have gone by and 50 is around the corner. Reality is setting in. I was diagnosed with basal cell skin cancer. And I have severe dry eye. She is an amazing eye doctor along with her other talents of skin care. I ended up needing my tear ducts cauterized. She performed this procedure and my quality of life has changed.

Come to find out the laser that I had done previously made a complete difference in the prevention of the basal cell on my face. I never even knew this could be helpful. I’m getting ready to have this procedure done again. Many talents and prevention’s are happening in this office. I wish I could spread the word to more people. I love the fact that I can look young and beautiful and help prevent things that can make me sick down the road. For more information please contact the staff. This office is so helpful and the staff is so incredible and amazing. I will definitely continue to go here for years to come.

By Susan B, Waimea, Hawaii
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Dry eye is a chronic condition that affects many in their daily lives, causing both discomfort and blurry vision. This can interfere with driving, watching TV or especially working on the computer.

Symptoms may include redness, gritty feeling, dryness, itching, blurry vision, light sensitivity or even excessive tearing, which is a compensatory response to the dryness. Causes include age, changing hormones, use of antihistamines or other medications as well as autoimmune disorders. Sometimes changing their medication(s) to a different class can relieve their symptoms. It is important to see your ophthalmologist for an evaluation if you are suffering from any of these symptoms. Then she can diagnose the cause of your problem and make your eyes more comfortable and also stay healthier in the long run.

Lacking a protective layer of water or oil in their tears, dry eye sufferers may try to compensate through excessive use of artificial tear eye drops, which may make the situation worse!

The thorough evaluation of dry eye at True Vision Center in Honolulu includes a thorough history with careful listening to each patient’s individual symptoms, then an examination with the slit lamp, which is a microscope that magnifies the eye 10 to 16 times. Then any necessary testing is done. Once all of the diagnostic evaluation is done, the doctor, together with the patient, designs a treatment plan that will be most suited for him or her.


There are many treatments for dry eye:

  1. Artificial tears, which most patients try first.
  2. Restasis, a prescription drop that helps the eye produce more of its own tears. Now available as a generic, cyclosporine 0.05% drop.
  3. Xiidra, a prescription drop that interrupts the inflammation caused by dry eye disease.
  4. Cequa, a stronger and more effective cyclosporine drop, that is often used instead of Restasis.
  5. Tyrvaya, a new medication that is sprayed inside of each nostril to stimulate a nerve to produce more tears.
  6. Eysuvis drops for relief of short term flare ups of dry eye symptoms.
  7. Punctal/canalicular plugs. These partially block the eye’s drainage system. This allows the eye to hold onto its own tears, supplemental artificial tears, and medications longer.
  8. Lacriserts, a tiny insert that is placed inside the lower eyelid once a day that slowly melts and changes the composition of tears so they evaporate more slowly.
  9. Autologous Serum Eye Drops, eye drops made from your own blood that is sterilely blended with preservative-free artificial tears. These drops contain healing factors that nourish the eye differently from any other drops.
  10. Artificial tear ointment, a very thick preparation of mineral oil and other lubricants may be indicated to protect the eyes from drying out while sleeping or if they do not close comletely.
  11. Surgical options include punctal cautery, which seals the tear drainage holes more closed than punctal plugs, and amniotic membrane graft, which provides more stem cells to improve tear production.

Any of these treatments may be used alone or in combination with each other to achieve the best result for each unique patient. Treating dry eye appropriately is important not only for the patient’s comfort, but also for long term health of the eyes. Untreated dry eye disease leaves the eyes prone to surface damage and severe infection. If treated appropriately, the risk of pain, infection, and scarring is greatly decreased.


To use an analogy, it’s like trying to partially fill a dry empty sink. You can either turn up the water flow higher (drops and Tyrvaya) or partially close the drain (plugs). In addition, if the eyes are inflamed due to the dry eyes, drops such as Eysuvis help settle the inflammation down.

Associated Diseases

Patients often have associated diseases that cause tear film instability. This very often includes meibomian gland dysfunction where the oil glands of the eyelids become clogged. The oil backs up into the eyelids. The eyelids get inflamed and cause burning of the eyes. Lack of oil in the tear film creates conditions where the tears dry out faster, especially in wind, dry heat or air conditioning. This may cause acute burning sensation.

Patients with meibomian glad dysfunction are treated with warm compresses to melt the thickened oil, doxycycline to change the composition of the oil, and Azasite drops which are both anti-inflammatory and change the composition of the oils.

In addition to local associated diseases, patients may have systemic diseases associated with dry eyes. These include:

  1. Sjogren’s Syndrome
  2. Rheumatoid Arthritis
  3. Systemic Lupus
  4. Diabetes Mellitus

It is extremely important to diagnose and treat all of these associated conditions as early as possible to prevent permanent damage to many organ systems. Dr. Tantisira will ask screening questions about these systemic diseases to see if you are at risk for having them. She takes care of all types of eye problems. Contact Dr.Tantisira at (808)591-9111 to see how she can help you care for your dry irritated eyes.

Dr. Tantisira has over 30 years’ experience with delicate surgery and Botox injections. She now features a wide assortment of cosmetic procedures in her Honolulu office. Contact Dr. Tantisira to see how she can help you achieve your desired appearance.

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