Dry Eye Therapy Honolulu

Dry eyes is a chronic condition that affects many in their daily lives, including when driving, watching TV or working on the computer.

Symptoms may include redness, gritty feeling, dryness, itching, blurry vision, light sensitivity or excessive tearing. Excessive tearing is a compensatory response to the dryness.

Lacking a protective layer of water or oil in their tears, dry eye sufferers may try to compensate through excessive use of eye drops, which may only make the situation worse! Other causes may include age, hormones, use of antihistamines and more.

Dr. Tantisira carefully listens to each patient’s individual symptoms, then does a thorough evaluation, including any testing necessary, to evaluate her patient’s for dry eyes in her Honolulu office. Together with the patient, she designs a treatment plan that will be most suited for that particular patient.


There are several treatments for dry eyes after patients have tried artificial tears:

  1. Restasis, a prescription drop that helps the eye produce more of its own tears.
  2. Xiidra, a prescription drop that interrupts the inflammation caused by dry eye disease.
  3. Punctal/canalicular plugs. These partially block the eye’s drainage system. This allows the eye to hold onto its own tears and supplemental artificial tears longer.
  4. 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
  5. 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.
  6. 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.

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

If the dry eye problem is very severe, Lacriserts, autologous serum eye drops, and/or artificial tear ointment may also be helpful in controlling the signs or symptoms of the disease. 

Occasionally, for very dry eyes, both eye drop and plug treatments are necessary.

Treating dry eye appropriately is important not only for the patient’s comfort, but also for long term health of the eyes. 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.

Associated Diseases

Sometimes patients have associated diseases that cause tear film instability. This may include meibomian gland dysfunction where the eyes’ oil glands become clogged. The oil backs up in the eyelids; they get inflamed and cause burning of the eyes. Lack of oil in the tear film allows the tears to dry faster especially in wind or air conditioning. This also causes burning and dryness.

Patients 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:

    • Sjogren’s Syndrome
    • Rheumatoid Arthritis
    • Systemic Lupus
    • Diabetes Mellitus

It is extremely important to diagnose and treat all of these conditions as early as possible to prevent permanent damage to many organ systems. Dr. Tantisira will ask screening questions about these other diseases to see if you are at risk for having the diseases.

In addition, many patients experience dry eye as a side effect of the medication(s) that they are taking, such as for allergy treatment or for high blood pressure. Sometimes changing their medication(s) 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.