Dry Eye

Expert Care and Treatment for Dry Eye Syndrome

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If you’re one of the millions of Americans with dry eye syndrome, you know the redness, irritation, blurriness, and gritty feeling it can cause. Whether dry eye is caused by a related disease, a hormone imbalance, or too much screen time, Duke corneal specialists can assess your condition and recommend the treatment plan that’s best for you.

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Should You See a Doctor for Dry Eye?

It’s important to get prompt diagnosis and treatment for dry eyes. That’s because dry eye syndrome can worsen over time. If the cause is chronically inflamed glands, it can lead to irreversible damage. 

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Treatments for Dry Eye

Getting relief for dry eye can involve trying different over-the-counter products, prescription medications, and more advanced approaches. Our doctors may recommend one or more of these treatments, depending on what works best for you:

Over-the-Counter Products

Lubricating eye drops, gels, and ointments add moisture to your eye. Omega-3 and omega-6 fatty acid supplements may also provide relief.

Prescription Eyedrops

Anti-inflammatory eye drops help your eyes produce tears. Steroid and antibiotic eye drops may be prescribed to reduce inflammation in the glands. 

Punctal Plugs

Silicone or collagen plugs close the holes in the corners of your eyelids where tears normally drain; instead, tears stay on the surface of your eye longer. 

Punctal Cautery

If punctual plugs don’t work for you, your doctor may recommend this in-office procedure that permanently closes your tear drainage ducts. 

Scleral Lenses

Special dome-shaped hard plastic contact lenses rest on the white part of your eye. A pool of saline solution lies underneath the large contact lens to lubricate your dry eye.

Intense Pulsed-Light Therapy

Bursts of light are directed at your lower-eyelid and upper-cheek areas to heat blocked eyelid glands. Then your glands are expressed to relieve material clogging your tear ducts, eyelids, and glands. Treatment typically consists of four initial monthly treatments, followed by biannual or annual treatments to maintain your results. This treatment is not covered by insurance.

LipiFlow Thermal Pulsation System

This treatment can improve the health of the meibomian glands -- the oil glands on the edge of your eyelids where your eyelashes are located. After your eye is numbed with anesthetic drops, an eyepiece is placed between the upper and lower eyelids. It warms and massages your eyelids. The intensity gradually increases during the 12-minute session to express any blockages in the glands. After the procedure, you may have temporary eyelid redness for up to 24 hours. Relief from dry eye occurs during the next four to six weeks. This procedure may be repeated every nine to 24 months to maintain dry eye relief. It is not covered by insurance.

Manual Expression of Glands

Heating the meibomian glands and manual expression can remove obstructions and encourage the glands to secrete more oils. A warming device is applied to the upper and lower eyelids. The heat gradually increases during the 15-minute session. Then, your doctor uses a tool to manually release any blockages in the glands. Dry eye relief occurs during the next four to six weeks. This procedure may be repeated every 6 to 12 months. It is not covered by insurance.

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A comprehensive dry eye evaluation will determine which type of dry eye you have -- evaporative dry eye or aqueous-deficient dry eye -- and help your doctor recommend the most appropriate treatment. Your evaluation may include one or more of these tests:

Visual Acuity

This exam determines how well you can read letters on a standardized chart.


This test measures your eye pressure to determine your risk for glaucoma.

Slit Lamp Exam

This exam provides a magnified 3D view of the structures at the front of your eye.

Dilation Exam

Dilating drops eye drops enlarge your pupils so your doctor can evaluate the inner structures of your eye.

Vital Dyes

Stains are carefully placed on the surface of your eye to detect patterns created by cells damaged by dry eye.

Schirmer Testing

Strips held under your eyelid measure your tear production.

Lipiview Testing

Digital images measure the thickness of the oil (lipid) layer of the tear film. This test helps your eye doctor determine if you have evaporative dry eye disease.

Non-Contact Tear Break-Up Time

This test creates images of the surface of your eye and measures how quickly the tear film breaks up on your eye’s surface.

Tear Osmolarity Testing

A small computerized device quickly touches the white part of your eye to capture a microscopic amount of tears. The test determines the severity of your dry eye disease by measuring the salt content of your tears.

Meibomian Gland Imaging

This noninvasive imaging technology helps your doctor assess the lipid layer of your tear film as well as the anatomy and structure of the oil-producing glands in your eyelids. This can help determine the cause of dry eye.

Best Eye Hospital in North Carolina

Where you receive your care matters. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our ophthalmology program is ranked seventh in the nation and is the highest-ranked program in North Carolina, according to U.S. News & World Report for 2024–2025.

Seek Dry Eye Care From an Experienced Ophthalmologist

National Leaders in Dry Eye Syndrome
Our ophthalmologists travel the country to lecture and teach courses on dry eye procedures. Our extensive experience and knowledge mean you receive care from some of the best corneal specialists in the country.

Latest Retinal Imaging Devices
We use sophisticated imaging devices and noninvasive testing to evaluate the condition of your eyes and determine the best treatment for your individual needs.

Advanced Dry Eye Treatments
Our eye specialists are among the few in the country with extensive training in the most advanced dry-eye treatments available: intense pulsed light therapy and the LipiFlow thermal pulsation system.  

Fast and Convenient Treatment Options
Many treatments for dry eye can be done in the convenience and comfort of our offices. The procedures are quick and require very little downtime, so you feel better faster.

This page was medically reviewed on 05/19/2023 by