Dry Eye Management in Hillsborough, NJ
Dry eye disease affects millions of Americans and is one of the most common reasons people visit an eye doctor. Despite how widespread it is, many patients spend years managing symptoms with over-the-counter drops without ever addressing the underlying cause. At Amwell Eye Care, Dr. Adam Zhao takes a comprehensive, personalized approach to dry eye management — identifying the root cause of your symptoms and building a treatment plan designed to provide lasting relief, not just temporary comfort.
What Is Dry Eye Disease?
Dry eye disease occurs when your eyes either don’t produce enough tears, or produce tears that evaporate too quickly due to poor quality. A healthy tear film has three layers — an oily outer layer, a watery middle layer, and a mucus inner layer. When any of these layers is disrupted, the tear film becomes unstable, leading to dryness, irritation, and in chronic cases, damage to the surface of the eye.
There are two primary types:
- Aqueous deficient dry eye — the lacrimal glands don’t produce enough watery tear volume to keep the eye surface adequately lubricated
- Evaporative dry eye — the most common type, usually caused by meibomian gland dysfunction (MGD), where the oil-producing glands along the eyelid margins become blocked or inflamed, causing tears to evaporate too rapidly
Many patients have a combination of both. Identifying which type — and what’s driving it — is the first step toward effective treatment.
Common Symptoms of Dry Eye Disease
Dry eye symptoms vary widely from person to person. You may be experiencing dry eye disease if you have any of the following:
- Persistent dryness, scratchiness, or a gritty “sandy” sensation in the eyes
- Burning or stinging, especially in dry or windy environments
- Watery eyes — paradoxically, excess tearing is a common dry eye symptom caused by reflex tearing in response to irritation
- Blurry vision that fluctuates throughout the day or clears temporarily with blinking
- Eye fatigue or discomfort during prolonged screen use, reading, or driving
- Redness, especially toward the end of the day
- Sensitivity to light
- Difficulty wearing contact lenses comfortably
- A feeling that something is in your eye
What Causes Dry Eye Disease?
Dry eye has many contributing factors, and effective management requires understanding which ones are relevant to you. Common causes and risk factors include:
- Age — tear production naturally decreases with age; dry eye is significantly more common after age 50
- Hormonal changes — particularly in women during menopause, pregnancy, or when using oral contraceptives
- Meibomian gland dysfunction (MGD) — blockage or inflammation of the oil-secreting glands along the eyelid margins
- Blepharitis — chronic eyelid inflammation that disrupts the tear film and contributes to evaporative dry eye
- Screen use — prolonged digital device use significantly reduces blink rate, increasing tear evaporation
- Contact lens wear — lenses can disrupt the tear film and accelerate evaporation
- Medications — antihistamines, antidepressants, blood pressure medications, and decongestants can all reduce tear production
- Environmental factors — air conditioning, heating, wind, and low humidity all accelerate tear evaporation
- Autoimmune conditions — Sjögren’s syndrome, rheumatoid arthritis, and lupus are associated with severe aqueous deficient dry eye
- Prior eye surgery — LASIK and other refractive surgeries can temporarily or permanently affect tear production
How We Diagnose Dry Eye at Amwell Eye Care
Before recommending any treatment, Dr. Zhao performs a thorough dry eye evaluation to identify the type and severity of your condition and its underlying causes. This includes:
- Tear film assessment — evaluation of tear stability, volume, and evaporation rate
- Meibomian gland evaluation — examination of the eyelid glands for blockage, dropout, or inflammation
- Ocular surface staining — special dyes reveal any damage to the corneal or conjunctival surface caused by dryness
- Blink analysis and eyelid examination — incomplete blinking and eyelid abnormalities are common contributors to evaporative dry eye
- Symptom questionnaire — standardized scoring helps track symptom severity and monitor improvement over time
Dry Eye Treatment Options
Because dry eye disease has multiple causes and presentations, there is no single solution that works for everyone. Dr. Zhao creates individualized treatment plans that may combine one or more of the following approaches:
Artificial Tears and Lubricating Drops
Preservative-free artificial tears are often the first line of symptomatic relief. Dr. Zhao will recommend specific formulations based on your tear film deficiency type — watery drops for aqueous deficiency, gel-based or oil-containing drops for evaporative dry eye.
Warm Compresses and Lid Hygiene
For patients with meibomian gland dysfunction or blepharitis, daily warm compresses soften and express blocked meibum, improving oil flow into the tear film. Lid scrubs and cleansers reduce bacterial load and eyelid inflammation.
Prescription Anti-Inflammatory Treatments
Chronic dry eye often involves inflammation of the ocular surface. Prescription cyclosporine drops (Restasis, Cequa) and lifitegrast (Xiidra) target the inflammatory cycle that perpetuates dry eye disease, addressing the condition at a deeper level than lubricating drops alone.
Punctal Plugs
Punctal plugs are tiny, biocompatible devices inserted into the puncta — the small drainage openings at the inner corner of each eyelid — to slow the drainage of tears from the eye surface. By keeping your natural tears in contact with the eye longer, punctal plugs provide sustained relief for patients with aqueous deficient dry eye. The procedure is quick, painless, and performed right in our office. Temporary dissolvable plugs are available for patients who want to trial the treatment before committing to semi-permanent options.
Intense Pulsed Light (IPL) Therapy
Intense Pulsed Light therapy is one of the most effective in-office treatments available for evaporative dry eye caused by meibomian gland dysfunction. IPL uses carefully calibrated pulses of broad-spectrum light applied to the skin around the eyelids to reduce inflammation, liquefy blocked meibum, close abnormal blood vessels that contribute to lid inflammation, and stimulate healthier meibomian gland function. Originally developed for dermatology, IPL has become a well-established dry eye treatment backed by strong clinical evidence. A typical course involves a series of sessions spaced 3–4 weeks apart, with most patients experiencing significant, lasting symptom improvement. IPL is particularly beneficial for patients who have not achieved adequate relief from drops and lid hygiene alone.
Omega-3 Nutritional Supplements
High-quality omega-3 fatty acid supplements support meibomian gland function and help reduce eyelid inflammation from the inside out. Dr. Zhao will recommend pharmaceutical-grade formulations when appropriate as part of a broader treatment plan.
Scleral Contact Lenses
For patients with severe dry eye or irregular corneal surfaces, scleral lenses — large-diameter rigid lenses that vault over the cornea and rest on the white of the eye — create a fluid reservoir that keeps the ocular surface continuously hydrated throughout the day.
Insurance & Scheduling
Dry eye evaluations and many treatments are covered under medical insurance as medically necessary services. IPL therapy and some in-office procedures may not be covered by all plans. Our staff will review your benefits and discuss all costs transparently before beginning any treatment. We accept Medicare, VSP, Aetna, Blue Cross Blue Shield, EyeMed, and most major plans.
Not sure if what you’re experiencing is dry eye disease? Read our full guide to understanding dry eye — covering causes, tear types, and symptoms — before scheduling your evaluation.
To schedule a dry eye evaluation in Hillsborough, NJ, contact us online or call (908) 336-3886. Same-week appointments are often available.
Find Lasting Relief from Dry Eye Today
You don’t have to live with the discomfort of dry eyes. A personalized treatment plan starts with a comprehensive evaluation — book yours today.
